CRISPR REVOLUTION THE. Northwestern Medicine scientists usher in a new era of genetic research 16 INSIDE A REMARKABLE YEAR 10 ONCOLOGY CLOSE-UP 20

WINTER 2018

THE

CRISPR REVOLUTION

Northwestern Medicine scientists usher in a new era of genetic research • 16

INSIDE A REMARKABLE YEAR • 10

ONCO

Author Darrell Norton

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JOURNAL TRANSCRIPT
WINTER 2018

THE

CRISPR REVOLUTION

Northwestern Medicine scientists usher in a new era of genetic research • 16

INSIDE A REMARKABLE YEAR • 10

ONCOLOGY CLOSE-UP • 20

FULL SPECTRUM OF GYNECOLOGIC CARE • 24

PRECISION PATHOLOGIST • 28

FIRST GLANCE

Northwestern Medicine Community Spotlight

A Lighter Side of Medical School JAMMING AT IN VIVO

Northwestern Medicine magazine is published quarterly for alumni and friends of Northwestern University Feinberg School of Medicine, Northwestern Memorial HealthCare and the McGaw Medical Center of Northwestern University.

John Flaherty, MD, professor of Medicine in the Division of Infectious Diseases, jams with second-year medical student Nick Volpe in a performance by “The Hypochondriacs” during the 39th annual production of In Vivo, Feinberg’s popular sketch comedy and variety show.

Editorial Advisors: Eric G. Neilson, MD, vice president for Medical Affairs and Lewis Landsberg Dean; Alan Krensky, MD, vice dean for Development and Alumni Relations; Nicole Mladic, executive director of Communications; Babette Nyka, director of Alumni Relations

Editor: Nora Dunne

Alumni Association: James P. Kelly, ’73 MD, President; Rishi Reddy, ’00 MD, President-elect

Editorial Assistant: Yesenia Navarro

Design: Taylor Design

Contributing Writers: Amber Bemis, Will Doss, Marla Paul, Cheryl SooHoo, Anna Williams

Call or email us at 312-503-4210 or [email protected] ©2017 Northwestern University. Northwestern Medicine® is a federally registered trademark of Northwestern Memorial HealthCare and is used by Northwestern University. Material in Northwestern Medicine magazine may not be reproduced without prior consent and proper credit.

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Address all correspondence to: Northwestern University, Feinberg School of Medicine, Office of Communications 420 E. Superior Street, Rubloff 12th Floor Chicago, IL 60611 PHOTOG R APHY BY Randy Belice

Winter 2018

NORTHWESTERN M EDICIN E MAGA ZIN E

CONTENTS

Features

10

16

A REMARKABLE YEAR

THE CRISPR REVOLUTION

Reflecting on the medical school’s

Northwestern Medicine scientists usher

accomplishments in 2017.

in a new era of genetic research.

20

24

ONCOLOGY CLOSE-UP

28

FULL SPECTRUM OF GYNECOLOGIC CARE

PRECISION PATHOLOGIST

the Lurie Cancer Center at the forefront

New clinical programs provide collaborative,

in the field of pathology.

of its field.

cutting-edge care for women of all ages.

Discover a program and a leader putting

Daniel Brat is spearheading transformations

Departments LEADERSHIP

PULSE

ALUMNI

WARD ROUNDS®

02 Looking Forward in 2018

03  On Campus  New Simpson Querrey Center

31 Alumni President’s Message 32 Alumni Profile

41 Artifacts From Special Collections

for Epigenetics, Exploring a



Mummy’s Secrets

34 Campaign Update 35 Progress Notes 40 Perspective

06 Research Briefs 08 Media Spotlight 09 Faculty Awards & Honors



Ora Hirsch Pescovitz, ’79 MD

W  illiam Weber, ’17 MD, ’17 MPH

ON THE COVER CRISPR-Cas RNA silencing complex. Computer model shows a max protein (green) bound to a strand of DNA (pink). Max, a member of the basic helix-loop-helix leucine zipper family of transcription factors, is involved in cell proliferation, differentiation and apoptosis. Transcription factors are proteins that bind to specific sequences of DNA and control the transcription of genetic information from DNA to RNA. (Laguna Design/Science Source)

MAGA ZIN E . N M .ORG

1

LEADERSHIP

Looking Forward in 2018

Eric G. Neilson, MD

Dean M. Harrison

E

VERY TREATMENT EVER OFFERED TO A PATIENT was once an experiment in a lab, fueled by years of scientific effort. As we reflect on our successes in 2017 and plan for what is to come in 2018, it’s important to acknowledge our commitment to developing the treatments that will become tomorrow’s cures and to providing the most advanced healthcare to our patients. This reminds us of our purpose as we close one year and begin anew. At Feinberg, we have made great strides to deliver on the promise of our mission to improve human health through education and discovery. Our students and trainees arrived on campus this year with extraordinary backgrounds (the new MD Class of 2021, for example, had median GPA and MCAT scores in the 98th percentile), and our graduates left with even more ambition and passion than when they came. These achievements are thanks to the exceptional faculty mentors in our educational programs and our innovative curriculum that emphasize flipped classrooms, team-based learning exercises, simulation, patient communication and student research. We are more confident than ever that our graduates are prepared to reshape the field of medicine. Our research enterprise, too, continues to reach new heights. In the last year, our scientists published 238 papers in highprofile journals and funding grew more than 6 percent, confirming the prestige and impact our investigators have in their fields.

2

NORTHWESTERN M EDICIN E • WINTER 2018

Construction of the Louis A. Simpson and Kimberly K. Querrey Biomedical Research Center is on track and will soon provide the space to grow our research enterprise even more. In this issue of Northwestern Medicine magazine, we highlight many of the ways we are solidifying our place in emerging research areas: Our new Simpson Querrey Center for Epigenetics will investigate how environmental conditions impact the human genome. Our OncoSET program combines oncology with genomic sequencing to offer cutting-edge cancer care personalized to individual patients, while our new chair of Pathology leads national efforts to incorporate molecular findings into brain tumor diagnoses. And our cover story describes how many of Feinberg’s laboratories are using innovative CRISPR-Cas9 gene editing techniques to better understand human disease and improve therapies. The health system also enjoyed another successful year: Northwestern Memorial Hospital was ranked the top hospital in Chicago and Illinois for the sixth straight year and No. 13 nationally by U.S. News & World Report. We made improvements in physician and staff engagement and continued to report strong financial performance. We expanded the Bluhm Cardiovascular Institute to two Northwestern Medicine hospitals (bringing the total to four hospital locations), opened two new gynecology programs at Northwestern Memorial Hospital and expanded the Advanced Lung Disease Clinic to the northern suburbs. We also introduced the first combined MRI-PET machine to Chicago and began performing innovative new procedures, including implanting a novel device to manage advanced heart failure and another to give men with enlarged prostates a minimally invasive treatment option. Looking forward, this spring we will be activating our system-wide electronic health record and opening the new Northwestern Medicine Lake Forest Hospital. These efforts are more examples

98 th percentile CLASS OF 2021’S MEDIAN GPA AND MCAT SCORES

238 PAPERS BY NORTHWESTERN MEDICINE SCIENTISTS PUBLISHED IN HIGH-PROFILE JOURNALS

6% INCREASE IN RESEARCH FUNDING

#1 and #13 NORTHWESTERN MEMORIAL HOSPITAL RANKING IN CHICAGO AND ILLINOIS (#1) AND IN THE COUNTRY (#13)

of our Patients First mission and our relentless drive to be better. It is worth taking stock of the remarkable things we have accomplished this past year — it inspires us to take on new challenges, feeds future discovery and forges stronger connections with our students, patients, mentees and collaborators. Our best wishes to all in the new year!

With warm regards, Eric G. Neilson, MD Vice President for Medical Affairs Lewis Landsberg Dean Dean M. Harrison President and CEO Northwestern Memorial Healthcare

PULSE

ON CAMPUS

New Epigenetics Center to Study Role of Environment on Genes $10 MILLION GIFT CREATES SIMPSON QUERREY CENTER FOR EPIGENETICS

Chromatin forms when DNA (orange) wraps tightly around histone proteins (purple).

A new $10 million gift from University trustees and supporters Louis A. Simpson and Kimberly

“At Northwestern, leading scientists are coming together to study not just the body but also the way the environment and our decisions affect our health.”

K. Querrey will create a center at Feinberg to study the effects of environment on the activation and expression of genes.

The new Simpson Querrey Center for

Epigenetics will investigate how environmental factors such as emotional experiences, chemical exposure, obesity, exercise, diet and

This year, Shilatifard’s laboratory and his

drug therapies can modify genes packaged in

biology, fundamental biology, epidemiology



human chromatin, causing them to become

and clinical medicine to develop foundational

collaborators published several groundbreak-

insights about how environmental conditions

ing discoveries reporting the development of

impact the human genome using sophisticated

epigenetic targeted therapeutics for childhood

molecular, biochemical and computational

leukemia, childhood brain cancer and adult

methods.

triple negative breast cancer. One study on

KEY DEFINITIONS

Epigenetics: the study of heritable

changes caused by modification of gene expression rather than alteration of the underlying DNA sequence that makes up genes

Chromatin: a complex of DNA and proteins that packages and protects DNA and controls gene expression and DNA replication



“Epigenetic-driven insights are proving

fundamental to a myriad of diseases including

childhood brain tumors led to a phase I clinical trial planned for this year at the Ann & Robert H.

cancer, heart, immunologic and neurological

Lurie Children’s Hospital of Chicago.

conditions,” said Eric G. Neilson, MD, vice



president for Medical Affairs and Lewis

requires creativity and collaboration,”

Landsberg Dean. “Understanding the details of how individual genes, groups of genes and environmental factors work together to deter-

“Solving the world’s biggest problems

Querrey said. “At Northwestern, leading scientists

mine the human condition is at the forefront

are coming together

of medicine today.”

to study not just the

more or less receptive to new biochemical



signals. Epigenetic modifications of chromatin

PhD, the Robert Francis Furchgott Professor

the environment and

can have a direct effect on the regulation of

of Biochemistry and Pediatrics and chair

our decisions affect

gene expression. Some of this regulation is

of Biochemistry and Molecular Genetics.

our health. Lou and

good, and some of it causes disease.

Shilatifard’s work focuses on understanding

I are thrilled to be a



the intricate chromatin mechanisms that

part of this ground-

regulate gene expression.

breaking work.”

The center brings together experts in bio-

chemistry, molecular genetics, computational

IMAG E Gunilla Elam/Science Source

The center will be led by Ali Shilatifard,

body but also the way

UPDATE The generous new gift from Simpson and Querrey brings their total giving to Northwestern to $164 million. See page 34 for a full update on We Will. The Campaign for Northwestern.

MAGA ZIN E . N M .ORG

3

PULSE

On Campus

The mummy was prepared 1,900 years ago in Egypt and excavated in 1911. A recent CT scan confirmed she was a 5-year-old girl.

Exploring a Mummy’s Secrets Scientists peered inside an ancient mummy using CT scans and synchrotron X-rays to learn about bone strength over time.

WRIT TEN BY Will Doss

USING THE BRIGHTEST X-RAY SOURCE IN



THE WESTERN HEMISPHERE, Northwestern

The Roman-Egyptian mummy resides at

the Garrett-Evangelical Theological Seminary

different directions. The angles at which the

Medicine scientists directed a narrow beam

on Northwestern’s Evanston campus. A cura-

X-rays diffract and the intensities of the differ-

of high-energy X-rays through an ancient

tor at Northwestern’s Block Museum of Art

ent diffracted beams reveal information about

mummy, aiming to reveal secrets about

stumbled upon it while investigating materials

the object’s structure, according to Stock.

within these nanocrystals scatter X-rays in

ancient Egyptian bone nanostructure that

for an exhibit this winter.



could help modern medicine better predict



intensities of these diffracted beams, then you

who might be at risk of fracture.

out disturbing the delicate portrait and wrap-

can identify what material it is — it’s like a fin-



pings, the curators contacted Stock to arrange

gerprint,” Stock said. “As far as I know, no one

Led by Stuart Stock, PhD, research

Wanting to discover what was inside with-

“If you know the angles and relative

professor of Cell and Molecular Biology, the

a CT scan at Northwestern Memorial Hospital.

has tried to non-invasively interrogate what’s

team used the Advanced Photon Source at

Stock agreed to perform the scan, but wanted

inside an object like this.”

Argonne National Laboratory this November

to go further: take the mummy to Argonne



to explore the structure of the mineral

National Laboratory to analyze bone nano-

petence, a measure of bone strength which

Stock was most interested in bone com-

constituents of the mummy’s bones without

structure using synchrotron X-ray diffraction.

becomes critical in osteoporosis.

disturbing the mummy’s wrappings.





Bone contains a high density of nanocrys-

tals and the periodic arrangement of atoms 4

NORTHWESTERN M EDICIN E • WINTER 2018

The most significant determinant of bone

competence is mineral density — the more

PHOTOG R APHY BY Jim Prisching and Northwestern University

On Campus

1

“W E’RE BASICALLY ABLE TO GO BACK TO AN EXCAVATION THAT HAPPENED MORE THAN 100 YEARS AGO AND RECONSTRUCT IT WITH OUR CONTEMPORARY ANALYSIS TECHNIQUES.”

The mummy underwent a CT scan at Northwestern Memorial Hospital in August.

mineral you have in your bones, the more

modern sedentary populations — is there a



they resist fracture. However, some older

difference in bone quality?”

the brain cavity are likely solidified pitch, not

individuals who have fractures also have



bones with high mineral density. According to

the mummy’s bones with that of the bones of

also investigating a scarab-shaped object,

Stock, some of this unexpected fracture risk

modern-day humans may quantify the bene-

her teeth and what look like wires near the

is explained by poorly structured trabecular

fits of an active lifestyle, improving clinicians’

mummy’s head and feet.”

ability to predict who is at risk for a fracture



bone — the porous bone present at the ends of

Comparing the mineral nanostructure of

“We have confirmed that the shards in

a crystalline material,” Stock said. “We are

The findings from the synchrotron

experiment, CT scan and other analyses

long bones — but that does not account for the

and enhancing preventative care.

whole discrepancy. Instead, it may be that the



quality of the bone tissue varies.

at bone density and trabecular bone structure

understand the life and death of this Roman

and maybe predict fracture risk correctly

mummy, according to Marc Walton, research

“AS FAR AS I KNOW, NO ONE HAS TRIED TO NON-INVASIVELY INTERROGATE WHAT’S INSIDE AN OBJECT LIKE THIS.”

“Right now in osteoporosis, we can look

will help investigators and historians better

80 percent of the time,” Stock said. “We need

professor of materials science and engineer-

to improve our predictive ability to around

ing at the McCormick School of Engineering.

95 percent, so we’ve got to track down addi-



tional factors.”

cavation that happened more than 100 years



ago and reconstruct it with our contemporary

In addition to bone composition, Stock

“We’re basically able to go back to an ex-

and colleagues will use X-ray diffraction

analysis techniques,” Walton said. “All the

say peak muscle mass and bone mass are pro-

patterns to identify other objects within the

information we find will help us enrich the



“There are epidemiological studies that

tective through life, particularly for women,”

mummy’s wrapping, matching the patterns

entire historic context of this young girl

Stock said. “I wanted to compare populations

measured at Argonne with the patterns of

mummy and the Roman period in Egypt.”

who had an active lifestyle with our more

other materials such as gold or rock.

2

In November, the mummy traveled to Argonne National Laboratory for a synchrotron X-ray experiment.

3

The angles and relative intensities of the diffracted beams revealed information about the body’s structure.

4

Scientists will study the mummy’s bone composition and identify other objects in her wrapping.

MAGA ZIN E . N M .ORG

5

PULSE

More details on these studies at magazine.nm.org

RESEARCH BRIEFS DISE ASE DISCOVE RI ES

STEM CELLS LEAD TO BETTER UNDERSTANDING OF RETINAL DEVELOPMENT

required to repress Rspondin-2 from the anterior part of the head where the eyes are eventually going to form.

“The prospect of using stem cell-based

therapies to treat different types of retinal diseases is becoming a real possibility; therefore, having a better understanding of the cellular and

Northwestern Medicine scien-

Immunostaining of a developing neuroretina (red) surrounding the lens (nuclei in yellow). F-actin-expressing cells are in green.

molecular processes controlling eye morpho-

tists used embryonic stem cells

genesis and neuroretina differentiation is

and induced pluripotent stem

critical,” said principal investigator Guillermo

cells to generate eye organoids

Oliver, PhD, the Thomas D. Spies Professor of

that mimic early eye development, creating a

Lymphatic Metabolism. Nozomu Takata, PhD,

tool that allowed them to characterize molec-

a postdoctoral fellow in Oliver’s lab, was the

ular events that regulate the formation of the

first author.

complex organ. The findings were published in



Cell Reports.

accurately recreate live organs in lab-grown



models, opening up possibilities for future

The scientists focused on the neuroretina,

The study also showed that stem cells can

a collection of eye cells that help convert light

research.

into neural signals, and identified the gene



Rspondin-2 as a critical player in mammalian

culture system as a reliable and fast alternative

neuroretina differentiation.

to identify and evaluate genes involved in eye



The authors found that during early

development, when the eye is initially forming and is still just an outgrowth of neural tissue, the activity of the transcription factor Six3 is

“Our results further validate the organoid

morphogenesis and neuroretina differentiation in vivo,” Oliver said. This work was supported by the National Eye Institute grant EY12162 and a Fellowship for Research Abroad from the Uehara Memorial Foundation.

CLI N ICAL B RE AK TH ROUG HS

Synthetic Cannabis-like Drug Reduces Sleep Apnea A synthetic cannabis-like drug in a pill was safe and effective in treating obstructive sleep apnea in the first large multi-site study of a drug for apnea funded by the National Institutes of Health. There is currently no drug treatment for sleep apnea, a sleep breathing disorder affecting about 30 million individuals in the United States. Untreated apnea raises the risk of heart disease, diabetes, sleepiness, cognitive impairment and a motor vehicle accident. Participants in the Northwestern Medicine and University of Illinois at Chicago trial had reduced apnea and decreased subjective sleepiness, according to the study, published in the journal SLEEP. 6

NORTHWESTERN M EDICIN E • WINTER 2018

The common treatment for sleep apnea is a CPAP (Continuous Positive Airway Pressure) device that delivers air to prevent collapse of the airway and breathing pauses. But adherence to the device can be challenging for many patients, some who simply stop using it. Investigators looked at the effect of dronabinol, a synthetic version of the molecule Delta-9 THC (tetrahydrocannabinol), which is in cannabis, on sleep apnea. The phase 2 trial, with 73 patients over six weeks, was the largest and longest randomized, controlled trial to test a drug treatment for sleep apnea. Dronabinol targets the brain rather than the physical problem of collapsing airways. This reflects the new belief that sleep apnea is not just a physical problem but may be caused

by multiple factors, such as poor regulation of the upper airway muscles by the brain, said co-lead author Phyllis Zee, MD, PhD, the Benjamin and Virginia T. Boshes Professor of Neurology and director of the Northwestern Medicine Sleep Disorders Center. “The CPAP device targets the physical problem but not the cause,” Zee said. “The drug targets the brain and nerves that regulate the upper airway muscles. It alters the neurotransmitters from the brain that communicate with the muscles. Better understanding of this will help us develop more effective and personalized treatments for sleep apnea.” This research was supported by grant UM1-HL112856 from the National Heart, Lung, and Blood Institute.

Research Briefs

M E DICAL E DUCATION

Comparing Physical Exam Education at U.S. Medical Schools The resources used to teach the physical exam to pre-clerkship medical students vary widely across U.S. medical schools, according to a study published in Academic Medicine. Teaching the physical exam is generally labor-intensive and requires significant human resources, including faculty, as well as standardized and actual patients, noted Toshiko Uchida, MD, Feinberg’s director of Clinical Skills Education and first author of the study. As such, there have been concerns that some medical schools may be providing inadequate physical exam training. In the study, investigators aimed to understand the various resources and

pedagogical approaches that U.S. medical schools employ to teach the physical exam to pre-clerkship students. The Directors of Clinical Skills Courses, a professional organization of clinical skills educators, administered a 49-question survey to all 141 medical schools accredited by the Liaison Committee on Medical Education. “Some schools likely don’t devote enough time or resources to teaching the physical exam in the pre-clerkship years,” Uchida said. “There is also a great need for further research to determine how much time is enough to learn the physical exam, and how best we can deploy our resources so that students begin to master physical exam techniques.”

SCI E NTI F IC ADVANCES

SUICIDE MOLECULES KILL ANY CANCER CELL Small RNA molecules originally developed as a tool to study gene function trigger a mechanism hidden in every cell that forces the cell to commit suicide, reports a Northwestern Medicine study. The RNA suicide molecules can potentially be developed into a novel form of cancer therapy, the study authors said.

Cancer cells treated with the RNA mole-

cules never become resistant to them because they simultaneously eliminate multiple genes that cancer cells need for survival.

Resources and Approaches Study Results

11

author Marcus Peter, PhD, the Tom D. Spies

6

%

MEDIAN HOURS devoted to teaching physical medical exam across all medical schools

30 HOURS OR LESS

“It’s like committing suicide by stabbing

yourself, shooting yourself and jumping off a building all at the same time,” said senior study

59

%



200 HOURS OR MORE

Professor of Cancer Metabolism.

The inability of cancer cells to develop

resistance to the molecules is a first, Peter said. He and his team discovered sequences in the human genome that when converted into small double-stranded RNA molecules trigger what they believe to be an ancient kill switch in cells to prevent cancer. He has been searching for the phantom molecules with this activity for

OF TH E TI M E S P E NT TE ACH I NG TH E P HYS ICAL E X AM

38

3O

%

%

USED STANDARDIZED PATIENTS

USED PEER-TO-PEER PRACTICE

25

%

USED ACTUAL PATIENTS

eight years.

“We think this is how multicellular

organisms eliminated cancer before the development of the adaptive immune system, which is about 500 million years old,” he said. “It could be a fail-safe that forces rogue cells to commit suicide. We believe it is active in every cell protecting us from cancer.”

P R ACTICE TI M E S P E NT WITH ACTUAL PATI E NTS

50

%

OF STUDENTS OBSERVED BY FACULTY



20

%

OF SCHOOLS NEVER HAD FACULTY OBSERVE STUDENTS

This study, which was published in the

journal eLife, and two other Northwestern studies in Oncotarget and Cell Cycle by the Peter group, describe the discovery of the assassin molecules present in multiple human genes and their powerful effect on cancer in mice. This research was funded by grants T32CA070085, T32CA009560, R50CA211271 and R35CA197450 from the National Cancer Institute.

MAGA ZIN E . N M .ORG

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PULSE

MEDIA SPOTLIGHT

Amish Mutation Protects Against Diabetes and May Extend Life Amish people living in a rural part of Indiana have a rare genetic mutation that protects them from Type 2 diabetes and appears to significantly extend their life spans, according to a new study published in Science Advances. The mutation affects a mysterious protein called plasminogen activator inhibitor-1, or PAI-1, that is known primarily for its role in promoting blood clotting.

Douglas Vaughan, MD, chair of Medicine, photo courtesy of Novocure

took a team of 40 investigators to Berne, Indiana, set up testing stations in a recreation center, and spent two days doing extensive tests on 177 members of the community, many of whom arrived by horse and buggy. “Some of the young men we collected blood from

Electric Fields Therapy Shows Promise for Brain Cancer Patients “My patients have been going skiing,” said Roger Stupp, MD, chief of Neuro-oncology in the Department of Neurology and lead author of a study published in JAMA that tested a home-based electrical field treatment known

fainted because they had never had a needle

as tumor-treating fields to help patients with glioblastoma. The treatment, for most, is surprisingly manageable. Doctors place four electrodes on a patient’s shaved scalp, where they’re worn for most of the day. The electrodes create low-intensity electrical fields within the brain that kill dividing cells. “I have a patient who I met here in Chicago who has gone on a safari in Africa twice now,” Stupp said.

Obesity, Poverty Help Explain Higher Diabetes Risk for U.S. Blacks

stick in their life,” said Vaughan. What he and his colleagues discovered was striking. Amish

other risk factors that may be possible to

carriers of the mutation live on average to

change, a U.S. study published in JAMA

age 85, about 10 years longer than their peers.

suggests. “To eliminate the higher rate of

Among the Amish who did not have the muta-

diabetes, everybody needs to have access

tion, the rate of Type 2 diabetes was 7 percent.

to healthy foods, safe spaces for physical

But for carriers of the mutation, the rate was

activity and equal economic opportunity to

zero, despite leading the same lifestyle and

have enough money to afford these things

consuming similar diets.

and live in communities that offer this,” Even though black adults are more likely to develop diabetes than white adults, the increased risk is largely due to obesity and

8

NORTHWESTERN M EDICIN E • WINTER 2018

said lead author Michael Bancks, PhD, a postdoctoral fellow in Preventive Medicine at Feinberg.

FACULTY AWARDS & HONORS

1

Mary McDermott, MD, ’92 GME, the Jeremiah Stamler Professor of Medicine in the Division of General Internal Medicine and Geriatrics and of Preventive Medicine, was named a Distinguished Scientist by the American Heart Association. The award honors prominent scientists and clinicians who have made significant contributions to the understanding of cardiovascular disease and stroke. McDermott has dedicated her research to lower extremity peripheral artery disease (PAD); her many accomplishments include demonstrating that supervised treadmill exercise improves walking ability among people with PAD, even when they are asymptomatic or have atypical leg symptoms. McDermott will also lead a new research network center sponsored

2

by the AHA focused on calf muscle pathology and disability in PAD. 1 Laimonis Laimins, PhD, the Guy and Anne Youmans Professor and chair of MicrobiologyImmunology, and Richard J. Miller, PhD, the Alfred Newton Richards Professor of Pharmacology, were named Fellows of the American Association for the Advancement of Science. Laimins was recognized for his contributions to the field of viral oncology, particularly for his studies on the differentiation-dependent life cycle of human papillomaviruses. Miller was recognized for his contributions to neuroscience and neuropharmacology, particularly in elucidating the role ion channels and receptors play in synaptic communication in health and disease. 2, 3

3

Firas Wehbe, MD, PhD, assistant professor of Preventive Medicine in the Division of Health and Biomedical Informatics, has been appointed Northwestern Medicine’s inaugural chief research informatics officer. 4 Patricia Garcia, MD, MPH, ’91 GME, professor of Medical Education and Obstetrics and Gynecology in the Division of MaternalFetal Medicine, was named associate dean for curriculum.

4

and Phil Hockberger, PhD, associate professor of Physiology, were named associate vice presidents to Northwestern University’s Office for Research. June McKoy MD, JD, MBA, was chosen to join the National Commission on Orthotic and Prosthetic Education (NCOPE) board of directors. The NCOPE is responsible for setting education standards of all professionals in the field of orthotics/prosthetics. 7

5

Alexis Thompson, MD, MPH, professor of Pediatrics in the Division of Hematology, Oncology, and Stem Cell Transplantation, has been named president of the American Society of Hematology. 6 Richard D’Aquila, MD, the Howard Taylor Ricketts, MD, Professor of Medicine in the Division of Infectious Diseases,

Emily Rogalski, ’07 PhD, was named one of Crain’s Chicago Business’s “40 Under 40.” She was recognized as a disruptor who is “upsetting the status quo” through her groundbreaking work with SuperAgers. William Gradishar, MD, the Betsy Bramsen Professorship of Breast Oncology and interim chief of Hematology and Oncology in the

5

Department of Medicine, was among the top 27 breast oncologists in the country based on data from Grand Rounds, a company that uses a machine learning algorithm to analyze publicly available and proprietary data about physicians, as reported by Forbes. Donald Lloyd-Jones, MD, senior associate dean for Clinical and Translational Research and chair of Preventive Medicine, was among the top 27 cardiologists. Amy Paller, MD, the Walter J. Hamlin Professor and chair of Dermatology, was selected by her colleagues in the Women’s Dermatologic Society to receive the 2018 Wilma Bergfeld, MD Visionary & Leadership Award. Peter Penzes, PhD, the Ruth and Evelyn Dunbar Professor of Psychiatry and Behavioral Sciences, was named director of Feinberg’s newly

6

7

announced Center for Autism and Neurodevelopment. The center’s mission is to catalyze scientific collaborations to better understand the biological bases of autism and related neurodevelopmental disorders and to translate those findings into new treatments. H. William Schnaper, MD, the Irene Heinz Given and John LaPorte Given Research Professor of Pediatrics in the Division of Kidney Diseases, received the 2018 American Society of Pediatric Nephrology Founders’ Award, which recognizes individuals who have made a unique and lasting contribution to the field of pediatric nephrology. scientific collaborations to better understand the biological bases of autism and related neurodevelopmental disorders and to translate those findings into new treatments.

MAGA ZIN E . N M .ORG

9

REFLECTING ON OUR

ACCOMPLISHMENTS IN 2017

A REMARKABLE YEAR Record-breaking research activity. A curriculum that better prepares students for clerkships. A new skyscraper takes shape on campus. Read on for some of the top news from the Feinberg School of Medicine in 2017.

HIGH-IMPACT RESEARCH A sampling of the breakthrough findings published by Feinberg-led research teams in the previous year.

Surgical residents across Simple behavioral interventhe country have grown tions can effectively curb accustomed to flexible inappropriate antibiotic duty hour requirements, prescribing, if adopted without rules on maximum for the long term. (Journal shift lengths and time off of the American Medical between shifts, which were Association) previously shown to be safe for patients and better for resident education. (New England Journal of Medicine)

Groundbreaking Molecular Discoveries

RESEARCH Feinberg’s Funding Surpasses $471 Million

S

ponsored research awards secured by principal investigators at the medical school grew to $471.7 million last fiscal year, a 6 percent increase over the previous year. “Feinberg’s remarkable research growth continued last year,

despite overall National Institutes of Health funding staying flat for medical schools as a whole,” said Rex Chisholm, PhD, vice dean for scientific affairs and graduate education.

“We’re proud to say that last year’s funding covered a wide variety

of disease-based science and cross-cutting biomedical themes,” he added. “Our strengths in leveraging big data, reducing health disparities and fundamental science have translated to new techniques and clinical questions that we’re just now beginning to explore.”

$471.7

72

+6

MILLION

PERCENT

PERCENT

The medical school’s sponsored research awards totaled $471.7 million in 2017.

Feinberg generated 72% of all research dollars at Northwestern University.

Sponsored research awards were up six percent in 2017 from 2016.

A new method of analyzing non-coding regions of DNA in neurons may pinpoint which genetic variants are most important to the development of schizophrenia and related disorders. (Cell Stem Cell)

Normal agers lose volume in the cortex, which contains neurons, twice as fast as SuperAgers, a rare group of older people whose memories are as sharp as those decades younger. (Journal of the American Medical Association)

The lab of Ali Shilatifard, PhD, the Robert Francis Furchgott Professor of Biochemistry and Pediatrics and chair of Biochemistry and Molecular Genetics, had a prolific year, publishing papers in journals including Science, Nature Medicine, Cell and Genes and Development. Among the discoveries, the team identified the genetic driver of mixed lineage leukemia and a targeted molecular “This work could not have therapy that halts the been done anywhere proliferation of leukein the world except mic cells. The scientists Northwestern Medicine, also found a molecule because of all the that stops the growth of aggressive pediatric brain scientists and physicians who have been recruited tumor diffuse intrinsic here during the past five pontine glioma, and they years and how they work learned that targeting together to link basic the SET1B protein in the scientific research to the cytoplasm of cells may be clinic.” – Ali Shilatifard able to treat triple-negative breast cancer. Other findings elaborated on scientists’ understanding of gene expression and embryonic stem cell development. Shilatifard will lead Feinberg’s new Simpson Querrey Center for Epigenetics (read more on page 3).

NORMAL AGERS lose volume in the cortex as they age

SUPERAGERS lose volume in the cortex at 1/2 the rate of normal agers

A promising bioactive nanomaterial has the potential to stimulate bone ­regeneration and improve quality of life for surgical patients and lead to less-­ invasive procedures. (Nature Nanotechnology)

MAGA ZIN E . N M .ORG

11

HIGH-IMPACT RESEARCH con’t The neuronal degeneration Inhibiting the process of in patients with Parkinson’s autophagy — a natural disease was linked to a toxic process of cell destruction cascade beginning with an that also plays a protective accumulation of oxidized role under stress conditions dopamine and the protein — may enhance the effects alpha-synuclein, providof radiation therapy for ing a possible therapeutic ­glioblastoma. (Cancer Cell) pathway. (Science)

ACADEMICS

The human immuno­ deficiency virus uses proteins called diaphanousrelated formins to hijack the cytoskeleton of healthy cells. (Proceedings of the National Academy of Sciences)

Number of New Students by Program

Two commonly used drugs, thyroxine and metformin, erased the learning and memory deficits in rat pups caused by fetal alcohol exposure when the drugs were given after birth, potentially identifying a treatment for the disorder. (Molecular Psychiatry)

161

30

Doctor of Medicine Program

Driskill Graduate Program in the Life Sciences

New MD Curriculum Assessed

L

ast fall, Northwestern Medicine

RECORD-BREAKING RESEARCH DAY

faculty described the medical school’s comprehensive curriculum

redesign, rolled out in 2012 with the

graduating class of 2016, and reported early outcomes on student achievement, confidence and engagement in a paper published in Academic Medicine.

Students’ U.S. Medical Licensing

Examination Step 1 and Step 2 scores stayed stable between the old and new curriculums, while student surveys demonstrated that those in the current curriculum felt significantly better prepared in clinical skills before entering clerkships compared to those who went

“We have significantly more clinical immersion now. [Students] see they are making a meaningful difference in patients’ lives, and that’s invigorating.”

through the former curriculum. Further, students reported greater confidence in

otherwise seemed dry,” explained

their professional development.

Heather Heiman, MD, leader of the



“We have significantly more clinical

curriculum’s clinical medicine element.

immersion now, and our students tell us

“[Students] see they are making a mean-

that as a result, when they see patients

ingful difference in patients’ lives, and

they understand the importance of

that’s invigorating.”

More than 400 abstracts showcased the diversity of innovative research taking place at Feinberg. The 13th Annual Lewis Landsberg Research Day last spring included projects on basic science research, clinical research, public health and social sciences research, and education research. Winners of the poster competition focused on areas of research spanning from myofilament components in arrhythmia and dilated cardiomyopathy to longitudinal studies of primary care clerkships and patient outcomes.

basic science content that might have

12

NORTHWESTERN M EDICIN E • WINTER 2018

PHOTOG R APH ABOVE LEF T BY Jim Prisching

Kaylin McMahon, ’17 PhD (L) and Doug Wilcox, ’16 PhD (R)

A unique population of immune cells called monocyte-derived alveolar macrophages plays a key role in the development of ­pulmonary fibrosis; targeting such cells could lead to new treatments for the disease. (The Journal of Experimental Medicine)

Celebrating PhD Students In 2017, Feinberg welcomed 30 new PhD students from as far away as Puerto Rico, Russia and India to the Walter S. and Lucienne Driskill Graduate Program (DPG) in Life Sciences. During the sixth annual Driskill Day last fall, DGP students and faculty received awards for their innovative research and mentorship.

20

15

4

3

1

Northwestern University Interdepartmental Neuroscience Program

Medical Scientist Training Program

Clinical Psychology PhD Program

Health Sciences Integrated PhD Program

Doctor of Physical Therapy/PhD Engineering Program

Among them, Kaylin McMahon, ’17 PhD, was recognized for her work developing bioinspired delivery vehicles for nucleic acid therapies for cancer, while Doug Wilcox, ’16 PhD, an MD/ PhD student in the Medical Scientist Training Program, received an award for his research on the age-dependent mechanisms of pathogenesis in herpes simplex virus encephalitis.

MAGA ZIN E . N M .ORG

13

CAMPUS

Early 2017

Late 2017

Simpson Querrey Biomedical Research Center Nears Completion “This building is a blend of a new construction and stacking on the Robert H. Lurie Medical Research Center. Each floor will be connected to the Lurie facility, and it will be wrapped with a full plaza featuring green space on the outside. The building will also have a sky bridge that connects to the Ward Building.” – Chris Jones, senior superintendent at Power Construction, general contractor of the project

14

NORTHWESTERN M EDICIN E • WINTER 2018

O

ver the course of 2017, the Louis A.



Simpson and Kimberly K. Querrey

sity broke ground on the building, extensive

In October, two years after the univer-

Biomedical Research Center progressed

mechanical, electrical, duct and piping work

from an extensive underground construction

was taking place behind the exterior of the

project to a 300-foot tall, 14-story structure.

building by more than 200 skilled trades



workers onsite.

In June, the Northwestern community

gathered to celebrate as a ceremonial steel



beam was set in place atop the Simpson

installing windows on the outside of the

Querrey Biomedical Research Center. The

building and begin connecting a bridge to the

ceremony marked a major milestone in the

Ward Building. The outdoor plaza work will

construction of the 600,000-square-foot

also start to take shape and the interior work

building, which will significantly expand the

on the lab floors will become a main focus.

medical school’s research enterprise.

Over the next year, the team will finish

Sketches from the plans for the new building, designed by architecture firm Perkins+Will.

HONORS Medical School and Hospital Affiliates Rank High

FACULTY RECOGNIZED WITH PRESTIGIOUS AWARDS 1

In 2017, Feinberg maintained its standing among the best

2

research-oriented medical schools in the country, placing 17th in the latest U.S. News & World Report rankings. Meanwhile, the company recognized

3

three Northwestern Medicine hospitals in its 2017–18 rankings of America’s Best Hospitals. The Shirley Ryan AbilityLab once again earned the top spot among rehabilitation hospitals in the country, and Lurie Children’s ranked first among children’s hospitals in Illinois.

4

Many Feinberg faculty were recognized nationally by their peers as leaders in their fields. Among them, Donald Lloyd-Jones, MD, ScM (1), senior associate dean for clinical and translational research and chair of Preventive Medicine, who was named Physician of the Year by the American Heart Association and a member of the Association of American Physicians. Karl Bilimoria, MD, ’08 MS, ’10 GME (2), director of the Northwestern Surgical Outcomes and Quality Improvement Center and the John Benjamin Murphy Professor of Surgery and Medical Social Sciences, and Sarki Abdulkadir, MD, PhD (3), the John T. Grayhack, MD, Professor of Urological Research and professor of Pathology, joined the American Society for Clinical Investigation. Melissa Simon, MD (4), the George H. Gardner Professor of Clinical Gynecology, was appointed to the U.S. Preventive Services Task Force to make evidence-based recommendations for preventive screenings, counseling services and medications.

MAGA ZIN E . N M .ORG

15

CRISPR THE

R E V O LU T I O N Northwestern Medicine scientists usher in a new era of genetic research. Written by Will Doss he McNally lab members were

three years, now would take just four to six

CRISPR AT FEINBERG

shocked.

months, allowing scientists around the world

Using CRISPR to edit the genomes of human



to more quickly understand mechanisms of

cells or model organisms has become a staple

used a new gene editing tech-

disease and more efficiently translate those

of research activities at Feinberg — especially

nique that promised to transform

discoveries from bench to bedside. At Feinberg,

when combined with induced pluripotent

how scientists investigated the

CRISPR gene editing is being used today in

stem cells (IPSCs).

human genome. Prior to that day in late 2014,

many settings, including to isolate mutations



editing genes in mammalian cells had been a

that cause neurological diseases and to run

a human subject, turn those into stem cells

time-consuming process — sometimes requir-

large-scale genetic screens to understand how

and direct the resulting IPSCs to develop into

ing screening hundreds of clones to find one

individual genes can damage — or protect

a specific type of tissue, such as cardiac cells,

with altered DNA — and it often ended in failure.

— cells.

neurons or skeletal muscle tissue. This tech-

But then, Eugene Wyatt, PhD, a postdoctoral



nique helps investigators identify cellular

fellow in the lab, generated a cellular model of

quick to point out that CRISPR-Cas9 is not just a

mechanisms of disease and can be com-

genetic disease in human embryonic kidney

laboratory tool; it also has tremendous potential

bined with CRISPR to isolate disease-causing

cells faster than ever before by harnessing a

for use in patients, though there are still unre-

mutations.

specialized region of DNA called CRISPR.

solved ethical and regulatory issues to think



T

For the first time, they had

Northwestern Medicine scientists are

Scientists can harvest adult cells from

For example, stem cells can be created

through before editing live human genomes.

using genetic material from patients with

showed evidence of editing,” says Elizabeth

But its first experimental use in patients is

amyotrophic lateral sclerosis (ALS), and

McNally, MD, PhD, the Elizabeth J. Ward

closer than most realize, according to McNally.

those cells differentiated into motor neurons.

Professor of Genetic Medicine and director



Investigators can compare those neurons to

of Feinberg’s Center for Genetic Medicine.

told you it will be ten years before somebody

neurons from healthy individuals, looking

“This was truly revolutionary — older methods

injects a patient with a genome-editing virus,”

for genetic mutations in the diseased model.

only worked in very specific cells and relied

McNally says. “Now I think it’s about two or

If they find a suspicious mutation, they can

on waiting for a cell’s natural machinery to

three years away.”

use CRISPR to reverse the genetic muta-

edit genes. With CRISPR, that machinery



tion, creating a stem cell line identical to the

could be directly introduced into the cells,

spinning pace at which CRISPR technology

patients’ cells, but without the mutation —

dramatically improving efficiency.”

is changing genetics. The first peer-reviewed

this is called an isogenic control line.



papers showing successful gene editing in



“More than 80 percent of the clones

Tasks such as creating a mouse model

of disease, which previously took about

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NORTHWESTERN M EDICIN E • WINTER 2018

“If you had asked me last year, I would’ve

That prediction underlines the head-

mammals were published just five years ago.

If you had asked me last year, I would’ve told you it will be ten years before somebody injects a patient with a genome-editing virus. Now I think it’s about two or three years away.

IMAG E Evan Oto/Science Source

MAGA ZIN E . N M .ORG

17

How CRISPR Works

Guide RNA

Just as CRISPR was transforming what scientists can do with cells, it equally changed the landscape for genetically engineering mice to model human diseases. The diagram at right illustrates how the CRISPR-Cas9 gene editing complex works. A sequence of RNA (green) programmed to find a specific segment of DNA (blue) is inserted into a cell along with the Cas9 enzyme (purple). Once the RNA finds the matching DNA, Cas9 cuts it. In that space, a fragment of donor DNA containing new genetic information (red) can be inserted.

Matching genomic sequence

Cas9

Donor DNA

“This allows us to test whether a

phenotype or defect in a motor neuron is caused by that particular mutation,” says

Repair

Evangelos Kiskinis, PhD, assistant professor of Neurology. “If the defect goes away, we’ve established the mutation is necessary for

Targeted genome editing

the defect.”

Kiskinis also uses CRISPR to do the

opposite experiment. He takes a healthy stem cell line, introduces the mutation using CRISPR and asks if that change is sufficient enough to induce the same phenotype.

This method becomes even more

important when looking at diseases caused

Parkinson’s disease is a loss of function in

compound, says Chandel, a member of the

by a combination of genes, such as epilepsy.

dopamine neurons, which are known to be

Robert H. Lurie Comprehensive Cancer Center

Kiskinis and his colleagues have introduced

vulnerable to oxidative stress.

of Northwestern University.

a known epilepsy-causing gene variant into a





variety of stem cell lines derived from healthy

Naturally those dopamine neurons will be the

mystery,” he says. “CRISPR positive-selection

individuals. They’re looking for insights into

most susceptible to damage from the pesti-

screens could be a way to figure it out.”

the impact of an individual’s broader genetic

cide,” says Chandel.

background and why certain people develop



epilepsy and others don’t.

lection screen, creating thousands of cells with

While there’s little legal or ethical debate



one individual gene turned off.

around using CRISPR with cultured cells or

this in human cells,” Kiskinis says. “Before,



non-embryonic stem cells, using the tool to

it was technically possible, but extremely

the majority of them died, but not all. Certain

edit the genome of living humans — especially

challenging; it would take a very long time.”

cells with knocked-out genes were resistant

in a manner where changes would be inher-



to paraquat, suggesting those genes may be

ited by children — is still uncharted territory.

large-scale genetic screens, a fast and simple

responsible for the toxicity. One gene in par-

Scientists in China reported using CRISPR to

way to investigate the effects of individual

ticular, called POR, was pinpointed as the main

edit a gene responsible for a deadly blood dis-

genes in cells. Navdeep Chandel, PhD, the

source of damage-causing oxidation, according

order in non-viable embryos, but few embryos

David W. Cugell, MD, Professor of Medicine,

to Chandel.

survived and it set the international scientific

used this method to narrow down which genes



community off into a fiery debate.

made a person vulnerable to Parkinson’s

dividends in the future, including in the



disease after repeated exposure to an herbi-

development of drugs designed to generate

but rather a question of when CRISPR-like

cide called paraquat.

oxidative stress in cancer cells, killing them

technology will be used in humans, according



“This is the first time we are able to do

Another application of CRISPR is in

“Paraquat generates a lot of oxidants.

His team conducted a CRISPR positive-se-

They then exposed the cells to paraquat —

Investigating oxidant stress could pay

“The biology of oxidative stress is still a

UNANSWERED QUESTIONS

However, it’s no longer a question of if,

while leaving healthy cells alone. While some

to Raj Awatramani, PhD, associate professor

farmers exposed to paraquat have a higher

drugs currently exist, not enough is known

of Neurology in the Division of Movement

risk of Parkinson’s disease. A major cause of

about their pathways to create a functioning

Disorders.

18

Epidemiological studies indicate that

NORTHWESTERN M EDICIN E • WINTER 2018

IMAG E Gunilla Elam/Science Source

Local Beginnings

F Human induced pluripotent stem cells that have been gene edited with CRISPR from the lab of Elizabeth McNally, MD, PhD.



“Society doesn’t keep pace with the

science,” says Awatramani, who uses CRISPR to create model neurons vulnerable to Parkinson’s disease. “We need to have new ethical guidelines to deal with genome editing in humans. Right now, it’s gray, gray and grayer.”

Several companies are racing to be the

first to use CRISPR in living humans, usually to treat serious chronic diseases such as HIV/AIDS or Duchenne muscular dystrophy, according to McNally. For Duchenne, the proposed treatments would involve injecting a patient — probably a young child — with a virus containing CRISPR material. Early models show that even if uptake only occurs in some cells, symptoms are relieved because the corrected cells tend to compensate for the diseased cells.

“It’s nerve-wracking when we’re talking

about children,” says McNally, who testified about the importance of using this method to treat genetic disease to the U.S. House of Representatives Committee on Science, Space and Technology in 2015. “Diseases like Duchenne muscular dystrophy are so difficult for patients and their families that it could be argued trying the therapy is the right thing to do, as long as it’s reasonably safe.”

Regardless of its future as a therapeutic

tool, CRISPR has entrenched itself as a central mechanism for genetics research, in an astonishingly short period of time. Combined with the adaptability of IPSC, the technologies have irrevocably changed genetics for the better.

“There’s no question, when people look

back 100 years from now, they’ll find it hard to believe all of this was discovered at the same time,” McNally says. “This is truly a revolutionary time for genetics.” 

irst discovered by Francisco Mojica in Spain in 1993, CRISPR is made up of short, repeated sequences of DNA and non-coding spacer DNA. Its purpose confounded investigators. But by 2003, Mojica had identified thousands of sequences of genetic code in CRISPR that matched snippets of bacterial and viral genomes. He hypothesized that CRISPR was part of an adaptive immune system that copies sequences from invading microbes to ward off viral infections of bacteria. Scientists around the world recognized CRISPR’s potential as an experimental tool and set out to investigate it further. Northwestern University was the setting of important research establishing the basic science behind CRISPR. In 2008, Luciano Marraffini, PhD, a postdoctoral fellow in the lab of Erik Sontheimer, PhD, then an associate professor of Biochemistry, Molecular Biology and Cell Biology at Northwestern’s Weinberg College of Arts and Sciences, became the first to empirically prove CRISPR destroys plasmid or virus DNA molecules directly and to suggest that it can be programmed to target any DNA. They published their findings in a landmark paper in Science. “Our work was a breakthrough in the understanding of CRISPR, since it explained how it works at the molecular level,” says Marraffini. Sontheimer adds, “Most important of all, we were the first to recognize and explicitly articulate the possibility that CRISPR could be repurposed for genomic engineering.” The pair filed a patent declaring CRISPR could be used to manipulate the genomes of complex organisms, but the patent was denied, citing lack of experimental demonstration. By then, other investigators had linked the CRISPR system with Cas9, an enzyme that modifies DNA, and begun to harness the whole complex for genome editing. The final breakthrough happened in January 2013, when five groups from around the world published We were the first to independent studies within three recognize and explicitly weeks showing the system could articulate the possibility be programmed to target specific points of DNA in mammalian cells. that CRISPR could be Among them were scienrepurposed for genomic tists from the Massachusetts Institute of Technology, who engineering. collaborated with Marraffini, then at The Rockefeller University, to publish a paper in Science demonstrating that the CRISPR sequence can be transcribed into short RNA sequences that drag Cas9 to a specific locus and cut the DNA, turning the targeted gene off. This discovery rocked the field of genetics: Just nine months after the initial Science publication, an additional 1,500 articles on the CRISPR-Cas9 complex had been published, refining and improving the tool. This was made possible by the decision to make CRISPR reagents readily available online with instructions to help scientists design the right experimental tools, says McNally.

MAGA ZIN E . N M .ORG

19

Oncology Discover a program and a leader putting the Lurie Cancer Center at the forefront of its field.

CURATED CANCER CARE Physicians and scientists in OncoSET are teaming up to help pioneer precision oncology.

U

ntil recently, treatment for patients with



cancer generally followed a broad-brush,

By all rights, I shouldn’t be alive, much less up and at it

“I am the beneficiary of research, pure and simple.

one-size-fits-all approach. Today, it is rec-

every day,” says Maniscalco, a year and a half after his

ognized that each cancer — just like each patient

diagnosis. “The team of people who are caring for me

— is unique.

at the Lurie Cancer Center are fabulous, but it is the



research that led to targeted treatments that is the key

Armed with the understanding that

distinct genetic mutations and abnormali-

to my life.”

ties are at the root of every patient’s cancer,



physicians and scientists now aim to usher in

premise of OncoSET, the flagship clinical and research

an era where treatment is truly tailored to the

program at the Lurie Cancer Center. First launched

individual. The hope is that providing thera-

in 2015, OncoSET is the Lurie Cancer Center’s entry

pies targeted to the specific genetic drivers of

into the emerging movement of precision medicine.

cancer will reduce the toxic side effects seen

Through an innovative three-step process — Sequence,

in less precise treatments and offer patients

Evaluate, Treat — the clinic couples oncology with

improved outcomes overall.

genomic sequencing to offer cutting-edge cancer care



personalized to each patient.

Such is the case with Chuck Maniscalco.

This is the potential of precision oncology, and the

In the fall of 2016, Maniscalco, a retired Chicago



business executive in his 60s, was diagnosed with

says Amir Behdad, MD, assistant professor of Pathology,

Stage IV lung cancer — a disease his mother

director of Cancer Molecular Diagnostics and co-direc-

and younger sister both died of years earlier.

tor of OncoSET’s Molecular Tumor Board. “If we can



attack only a target that’s unique to a patient’s tumor

In the past, his treatment options would

“This is really the most advanced form of oncology,”

typically have been limited to standard chemo-

cells — as opposed to globally attacking the body with

therapy. But after receiving genetic testing at the

chemotherapy — that’s a really attractive option.”

Robert H. Lurie Comprehensive Cancer Center



of Northwestern University, Maniscalco learned

become possible thanks to advances in genetic tech-

he had a mutation in the epidermal growth factor

nology. Next-generation sequencing has now enabled

receptor (EGFR), which can fuel cancer growth.

scientists to obtain a robust understanding of the

As a result, he was a candidate for Tarceva (erlo-

genetic profile of tumors, which had previously repre-

tinib), an oral medication that specifically targets

sented a significant challenge. With more knowledge of

the activity of the EGFR protein.

the molecular makeup of tumors, therapies designed

This strategy, Behdad notes, has only recently

“I am the beneficiary of research, pure and simple. By all rights, I shouldn’t be alive, much less up and at it every day. The team of people who are caring for me at the Lurie Cancer Center are fabulous, but it is the research that led to targeted treatments that is the key to my life.” CHUCK MANISCALCO Lung cancer survivor

The OncoSET Process Through an innovative three-step process, the Lurie Cancer Center’s flagship clinical and research program offers cutting-edge cancer care personalized to each patient.

20

NORTHWESTERN M EDICIN E • WINTER 2018

STEP 1: SEQUENCE

STEP 2: EVALUATE

STEP 3: TREAT

profile the tumor

evaluate the results

treat with targeted therapies

WRIT TEN BY Anna Williams

Close-up Top left and bottom right: Lurie Cancer Center members look for circulating tumor cells isolated from liquid biopsies; they hope to find mutations in the cells that will inform diagnosis and treatment for specific cancer patients. Top right: Massimo Cristofanilli, MD, director of OncoSET. Bottom left: Cancer leaders at the inaugural OncoSET Symposium last spring.

to target specific tumor markers have since

extensive genomic data, OncoSET informs

collaborations with commercial partners for

followed.

ongoing discovery of targeted cancer drugs

genetic testing, OncoSET leverages next-gener-



and helps advance pre-clinical research at

ation genomic sequencing to pinpoint changes

and technology are driving big changes in the

Feinberg and around the world.

in specific genes and produce a comprehensive

way we treat cancer, and as the leading cancer



profile of a patient’s tumors. (OncoSET is cur-

center in Chicago, we thought we should offer

we wanted to accomplish very quickly,” says

rently focused on analyzing solid tumors, but

precision medicine to our patients first,” says

Massimo Cristofanilli, MD, director of OncoSET

will soon also evaluate hematologic malignan-

Leonidas Platanias, MD, PhD, director of the

and associate director for Translational Research

cies, such as lymphoma and leukemia.)

Lurie Cancer Center. “I believe very strongly

at the Lurie Cancer Center. “One, of course, was



that this is the way medicine will be practiced

to be more precise in treatment planning for

— and one of only a few in the country — where

10 years from now.”

patients and establish the clinical service. But at

it doesn’t matter where the tumor is located.

the same time, we also wanted to advance trans-

What matters now is the composition of the

“We created OncoSET because science

“There were a couple of major goals

“We’ve created the first clinic in Chicago

A CLINICAL PROGRAM, INFORMING TOMORROW’S CURES

lation and feed our research purpose.”

tumor and the patient’s genomic analysis,”



explains Platanias, who is also the Jesse, Sara,

In addition to helping individual patients,

a simple blood draw from a patient for a

Andrew, Abigail, Benjamin and Elizabeth Lurie

there’s another, broader, benefit to the

liquid biopsy (in some cases, a traditional

Professor of Oncology.

OncoSET model: By collecting and analyzing

tissue biopsy is available as well). Through

PHOTOG R APHY BY Laura Brown

The OncoSET process begins with

MAGA ZIN E . N M .ORG

21



Every week, OncoSET’s Molecular Tumor



With that mission in mind, OncoSET

Board gathers to analyze the sequencing

hosted its inaugural symposium last spring,

results of individual patients, one by one.

sharing significant advances in precision



During this evaluation stage, it’s all hands

oncology with healthcare professionals from

on deck: The multidisciplinary team, co-di-

across the country and discussing strategies

rected by Cristofanilli and Behdad, is made up

for translating new discoveries into clinical

of medical, surgical and radiation oncologists,

practice. The Second Annual Lurie Cancer

along with pathologists, molecular scientists,

Center OncoSET Symposium: Practical

pharmacologists, radiologists, genetic counsel-

Applications of Precision Medicine will be

ors, bioinformaticians and other experts across

held May 17, 2018.

a range of specialties.





a prospective registry study — now totaling

In OncoSET, patients are also enrolled in

A DOCTOR AT HEART Deputy Director Maha Hussain oversees clinical research, but never forgets her primary goal: having an impact on patients.

the team devises an optimal treatment plan

more than 400 entries — which provides a

T

for each patient. That treatment, based on the

rich database for basic scientists investigat-

molecularly defined targets, might include an

ing particular mutations. The team is actively

clap with one hand.”

available drug or enrollment in an early-stage

working on developing retrospective analy-

clinical trial being conducted at Northwestern.

ses of treatment outcomes.



Informed by the tumor’s unique profile,



Since its inception, the

“We coordinate our data

Molecular Tumor Board has

with other institutions all

evaluated the genetic pro-

over the country. Eventually,

files of hundreds of patients, many of whom had advanced stage cancer or cancer that was unresponsive to standard treatment. Not only has the model made a real difference in individual patient outcomes, but with basic scientists at the table, new insights gleaned through the clinic may eventually serve as the building blocks of tomorrow’s targeted cures.

“After doing these gene

profiles and analyses of

“Eventually, after enough information has accumulated, there will be a tipping point — really a drastic change — in the way we practice oncology.” LEONIDAS PLATANIAS, MD, PHD Director of the Lurie Cancer Center

after enough information has accumulated, there will be a tipping point — really a drastic change — in the way we practice oncology,” says Platanias, also a professor of Medicine in the Division of Hematology and Oncology, and of Biochemistry and Molecular Genetics.

This new approach to

oncology is still at an experimental stage, of course, and the OncoSET team notes that as science and technology in

patients, we can bring all that information back to the lab,” Platanias explains.

this area rapidly evolve, so will the process of

“We can try to better understand some of the

providing precision cancer care. The program

abnormalities we detect — we still don’t know

is currently centered on genomics and molec-

the importance of many — conduct more

ular diagnostics, but in the future new tools

studies, develop new drugs and, eventually,

like epigenetic analysis, proteomic analysis

bring them back to the clinic.”

and metabolomics may also help match patients with the individualized treatment

PIONEERING A FUTURE OF PRECISION ONCOLOGY

plan that might benefit them most.

OncoSET has also emerged as a national

the more we will be bringing it back to

leader in advocating for a precision medicine

OncoSET to optimize our analysis,” Platanias

approach to cancer care and research.

adds. “We think this is the future, and we are



moving fast.” 

“One important focus for this program



“The more we understand in science,

is educating physicians on the value of this model,” says Cristofanilli, also a professor of Medicine in the Division of Hematology and Oncology. “We want to be on the forefront in demonstrating its utility.”

22

NORTHWESTERN M EDICIN E • WINTER 2018



here’s an old Iraqi proverb that has stuck with Maha Hussain, MD, since she left her native country: “You can’t For Hussain, deputy director of the

Robert H. Lurie Comprehensive Cancer Center of Northwestern University, it’s an idea at the core of her approach to personal and professional success.

“It takes a team,” Hussain says.

“Throughout my career, I have been successful in part because of collaboration with other people — whether it was colleagues I worked with or the support of my husband and family.”

Hussain, who joined Northwestern in

September 2016, is an internationally recognized authority on clinical research and a leading expert in genitourinary oncology, especially prostate and bladder cancer. She is also an active clinical investigator focused on novel therapeutics and a practicing oncologist at Northwestern.

“In some ways, I wear many hats.

But deep down, I’m a doctor at heart,” says Hussain, also the Genevieve E. Teuton Professor of Medicine in the Division of Hematology and Oncology. “I didn’t get into this just to sit in an office all day. Everything I do, even while in an administrative job, needs to have a direct or indirect impact on patients.”

As part of that mission, some of

Hussain’s chief responsibilities at the Lurie Cancer Center are enhancing clinical trial infrastructure, expanding clinical trial protocols, facilitating scientific translation and forging partnerships that grow clinical research opportunities for cancer patients.

To refer a patient or request a consultation, email [email protected] or call 312-472-1234.



“At Northwestern, we all provide

exceptional care. But I always say that exceptional care will never be good enough if we don’t have a cure or impactful

“There is an incredible willingness here to work together to impact patient outcomes through science, research, mentorship and excellence in medical care.”

in the mid-1980s. It was an exciting era, she says, with many discoveries, clinical trials and investments being made in research. Cures were becoming possible, such as in testicular cancer, and cancer was no longer automatically “a death sentence.” But while caring for patients in a local VA hospital, Hussain was also deeply discouraged by the lack of progress in prostate cancer. “It was just so awful to see men coming in with horrible disease, and you had really hardly anything to do for them,” Hussain says. “To me,

MAHA HUSSAIN, MD Deputy Director of the Lurie Cancer Center

it was a turning moment — I realized this is an area where there’s a clear need for impact. And I felt an urgent need to contribute.”

A FULL CAREER In her career since then, Hussain’s research and leadership have helped improve standards of care for metastatic hormone-sensitive and castration-resistant prostate cancer. She has authored close to 250 scientific publications and book chapters and taken leadership roles in a variety of national oncology committees. Amidst that work, she has continued to care for patients as a clinician and serve as a teacher and mentor. She has also put a priority on outside interests — her family, including a son and daughter, and hobbies such as travel, reading, photography, cooking and a robust treatments for our patients,” Hussain says.

Hussain and her husband, also a physician, left

“That’s why my passion is research. Research

to pursue their residency training abroad, just

is what will cure cancer.”

as the Iraq-Iran war was breaking out. After

was recruited to the University of Michigan,

social life. After her time at Wayne State, Hussain

three years in England, they landed in Detroit,

where she spent almost 14 years in top scien-

FROM BAGHDAD TO DETROIT

where a few of Hussain’s family members had

tific and leadership positions before joining

As far back as she can remember, Hussain has

already immigrated.

Northwestern.

always wanted to become a physician. Growing

The couple planned to return to Iraq after

“I was ready to take on the adventure of

up in Baghdad, her family encouraged her to

completing their training. “But there was one

working with a new team, with the wonderful

pursue her goals. “I never thought that because

war there after another, and we elected to stay,”

brain trust at Northwestern, in order to develop

I was a woman I shouldn’t be a doctor,” she says.

Hussain says. “It was the best decision we have

the best possible clinical research for our

“It was a very open culture, where education

ever made. Baghdad is our motherland, but the

patients,” Hussain says. “There is an incredible

and performance was the great equalizer.”

U.S. is our home.”

willingness here to work together to impact

After graduating from the prestigious Baghdad University College of Medicine in 1980,

Hussain was first drawn to oncology

patient outcomes through science, research,

during her residency at Wayne State University

mentorship and excellence in medical care.” 

IRAQ

ENGLAND

U.S.

WAYNE STATE

MICHIGAN

NORTHWESTERN

Graduates from medical school

Begins residency training

Continues residency, starts medical career

Begins prostate cancer research and treatment

Attains numerous scientific and leadership positions

Joins Feinberg as deputy director of Lurie Cancer Center

Journey to Northwestern Medicine Hussain’s arrival at Northwestern Medicine spanned three countries and two universities.

PHOTOGRAPHY BY Andre LaCour

MAGA ZIN E . N M .ORG

23

FULL SPECTRUM OF GYNECOLOGIC CARE

New clinical programs provide collaborative, cutting-edge care for women of all ages.

“I AM A VERY HAPPY PATIENT,” says Umang Singh of Lake Forest, Illinois. In summer 2003, after trying to start a family with no luck and seeing several doctors, Singh, then in her 30s, sought help from Magdy Milad, MD, MS, chief of Gynecology and Gynecologic Surgery at Northwestern Memorial Hospital. He found the cause of her infertility: advanced endometriosis. After undergoing small-incision laparoscopic surgery, Singh became pregnant five months later. Fast forward 13 years. In summer 2016, Singh, now a

WRIT TEN BY Cheryl SooHoo  •  ILLUSTR ATED BY Chris Gash

mother of three, began experiencing heavy uterine bleeding to the point of developing anemia. Her endometriosis had seemingly “returned with a vengeance.” She was told by a gynecologist that a radical hysterectomy and early menopause were in her immediate future, but didn’t believe that was her best option. Neither did Milad. That November, he performed a minimally invasive procedure that quickly alleviated Singh’s problem. From puberty to menopause, women like Singh keep their reproductive systems

healthy with annual checkups and general gynecologic care from their regular gynecologists and primary care physicians. But when routine care becomes something more challenging, obtaining specialized gynecological expertise for complex conditions can frequently result in a disjointed endeavor for patients and physicians alike. Many women must seek answers to their “female” problems on their own, going from one specialist referral to another to find care that best addresses their needs — until now.

MAGA ZIN E . N M .ORG

25

n July,

or tubal disease. While all very

Northwestern

common problems of the female

Medicine launched

reproductive system, they

the Center for

can sometimes become, well,

Comprehensive

complicated.

Gynecology (CCG)



at Northwestern Memorial

“We provide highly inte-

grated specialized care that

Hospital, with Milad as its

frequently goes beyond the

medical director. Featuring a

purview of the general obste-

one-of-a-kind multidisciplinary

trician/gynecologist,” explains

approach, the new center offers

Milad, who is also the Albert

women a unique one-stop shop

B. Gerbie, MD, Professor of

for highly specialized care for

Obstetrics and Gynecology and

complex gynecological disorders

chief of Minimally Invasive

and diseases. Housed in the Northwestern Medicine Lavin Family Pavilion, the center inte-

Gynecologic Surgery at Feinberg. “Many women with fibroids or in menopause, for example,

grates the expertise of minimally

receive wonderful care from

invasive gynecologic surgeons,

their regular doctors. But if a

interventional radiologists, phys-

woman has fibroids so large they

iatrists, physical therapists, psy-

are affecting fertility or severe

chologists and others. All working

menopausal symptoms that

together as a team in one place

are disrupting their lives, we

and space, these experts deliver

can help.”

collaborative leading-edge care



that is patient-centered rather

of the CCG is a particularly

than procedure-focused.

distinguishing feature, especially



“Our mission is to treat

The collaborative approach

in the case of fibroid treatment.

women across the spectrum of

Noncancerous uterine tumors,

their lives with leading-edge tech-

fibroids can cause a host of

nology and the latest therapies,”

symptoms from heavy menstrual

interventional radiologists and

says Serdar Bulun, MD, the chair

bleeding to pelvic pressure

gynecologists in one location to

and John J. Sciarra Professor of

and pain. Treatment strategies

jointly see patients.

Obstetrics and Gynecology. “Our

range from gynecologic surgery



approach is agnostic across the

(open and minimally invasive) to

Milad of this rare partnership.

specialties. It’s not a matter of

remove them and/or the uterus,

medical therapy versus surgery

to minimally-invasive interven-

versus an interventional radiol-

tional radiology procedures such

“Our mission is to treat women across the spectrum of their lives with leading-edge technology and the latest therapies.”

“It’s unheard of,” says

“Working physically side by side allows us to offer patients the best treatment strategy for their particular situation and provide

ogy procedure. Our goal is to

as uterine fibroid embolization

provide the best treatment and

(UFE) to shrink them. The

follow-up for each and every

options, though, are provided

patient.”

by different physicians: the

UN-COMPLICATING THE COMPLEX

latter, interventional radiologists.

pioneers in the relatively young

Typically, the two specialty areas

field, Northwestern Medicine’s

Every day, experienced phy-

work in separate silos, forcing

interventional radiology team is

sicians care for women with

patients to do the legwork.

a national leader in this innova-

fibroids, endometriosis, ovarian

Northwestern Medicine’s

tive, nonsurgical alternative to

cysts, uterine abnormalities

CCG may be the first to unite

hysterectomy.

former, gynecologists and the

26

NORTHWESTERN M EDICIN E • WINTER 2018

thorough follow-up as a team.”

UFE has only been avail-

able in the United States since the mid-1990s. One of the early

their doctor doesn’t know there

refer patients out to other spe-

are clinical experts with solu-

cialists, we bring experts from

tions to their problems,” says

dermatology, urogynecology and

Lauren Streicher, MD, ’83 GME,

other disciplines to the center to

medical director of a recently

see our patients.”

established Northwestern



Medicine clinical center focused

the CCG and CSMM provide

on filling this void in the care of

fertile ground at Northwestern

women.

Medicine for research and



medical training efforts focused

In October, the new Center

on complex gynecologic prob-

for Sexual Medicine and Menopause (CSMM) opened its

lems. In obstetrics and gyne-

doors. Sharing space and staff

cology, fellowships in minimally

with the CCG, the CSMM brings

invasive gynecologic surgery are

together a multidisciplinary team

among the most competitive in

of physicians, advanced practice Lauren Streicher, MD, ’83 GME, medical director of the Center for Sexual Medicine and Menopause works with state-ofthe-art technology, including a medical CO2 laser that stimulates vulvar and vaginal tissue to restore lubrication and elasticity.

Along with clinical care,

nurses, certified sex therapists and pelvic floor physical therapists. Comprised of three major areas of expertise, the center offers clinical programs in sexual medicine, menopause and vulvovaginal disorders. In addition to providing a broad array of both

“Unlike other programs that make the diagnosis and then refer patients out to other specialists, we bring experts to the center to see our  patients.”

the discipline across the country. For every one position, there are more than 60 applicants. Says Milad, “There’s a tremendous need for training gynecologists in complex surgical procedures.”

At the CSMM, opportuni-

ties will also abound for further educating not only physicians

hormonal and non-­hormonal

in training and those currently

treatment options, the clinic also

practicing, but also patients

features state-of-the-art technol-

themselves, according to

ogy such as the Mona Lisa Touch,

Streicher.

a medical CO2 laser that stimu-



lates vulvar and vaginal tissue to

intercourse and intimacy and

restore lubrication and elasticity.

even non-sexual hormonal issues

“Problems with sexual

SEXUAL HEALTH REVOLUTION



Many major academic

are somewhat taboo topics in the

Embarrassment prevents

medical centers provide some

doctor-patient relationship,” she says. “Increasing awareness will

many women from bringing up

level of sexual medicine or

difficulties with sex — from lack

menopause services, espe-

help to start the conversation

of desire to painful intercourse

cially for patients with specific

among women and let them

illnesses like cancer. The CSMM

know that help is readily avail-

mated 40 percent of women of all

not only addresses the impact

able, and they don’t have to just

ages have physical, medical, hor-

of other illness, such as diabe-

accept their situations for the

monal or emotional issues that

tes and heart disease, but also

rest of their lives.”

can interfere with intercourse

utilizes a collaborative approach

and intimacy.

that sets it apart.





— with their doctors. Yet an esti-

“Sexual medicine as well

as menopause are two unmet

“Sexual health and hor-

monal issues touch almost every

elements of women’s health that

medical specialty,” says Streicher,

often go unaddressed either

an clinical associate professor

because the patient is reluctant to discuss symptoms with their physician or the patient and/or

PHOTOG R APHY BY Laura Brown

of Obstetrics and Gynecology. “Unlike other programs that make the diagnosis and then

1: The Center for Comprehensive Gynecology (CCG) team, from left to right: Susan Tsai, MD, Angela Chaudhari, MD, Magdy Milad, MD, MS, and Patricia Handler, MSN. 2: Milad, medical director of the CCG, is chief of Gynecology and Gynecologic Surgery at Northwestern Memorial Hospital. 3: The two centers share space and staff in the Northwestern Memorial Lavin Family Pavilion.

MAGA ZIN E . N M .ORG

27

T

hough pathologists usually work behind the

the tumors into three distinct subtypes associated with a

scenes in laboratories, rather than face-to-face

tumor’s behavior and prognosis. These results, published

with patients, their role in clinical care is crucial.

“It’s estimated that about three-fourths of the

data in the electronic medical record is laboratory

in the New England Journal of Medicine, suggested that genetic status is a more accurate and consistent indicator of a tumor’s classification than the relatively subjective

data and at least two-thirds of clinical decisions are

process of histologic evaluation.

influenced by laboratory results,” says Daniel Brat, MD,



PhD, Feinberg’s new chair of Pathology.

that has been critical in our field,” Brat says. “We are



Pathology is also a field that’s rapidly evolving,

in parallel with advances in precision medicine and

“That study, among others, started a transformation

now incorporating molecular findings into our primary diagnoses — making them definitional, rather than an

a trend toward sub-specialization. Brat, a neuropa-

association. That was a big step for us.”

thologist who has spent nearly two decades studying



diffuse gliomas, is spearheading this evolution within

updated its international reference guide for classifying

the arena of brain tumor diagnostics while straddling

central nervous system tumors, outlining for the first

In 2016, the World Health Organization (WHO)

PRECISION PATHOLOGIST Written by Nora Dunne Photography by Teresa Crawford

the line between scientific investigation and the

time molecular parameters for defining tumors. Brat was

practice of medicine.

a heavily involved co-author.





“As the stewards of biospecimens, as well as the

“The WHO doesn’t want to incorporate test results

laboratory results and basic science findings that

into their diagnoses that the vast majority of the world

are derived from them, pathologists are in a prime

doesn’t have the tools or expertise to actually perform,”

position to advance understanding of human disease

he says. “However, it got to the point where we felt we

over the long term, while also supporting clinical

were doing patients a disservice by not incorporating

care on a daily basis,” Brat says.

molecular alterations into primary diagnoses — we knew too much about the different behaviors of specific molec-

FROM HISTOLOGY TO GENOMIC  ANALYSIS



For more than a century, pathologists have diagnosed

tic and testing guidelines through the College of American

ular subtypes of brain tumors.” Brat is now leading national efforts to devise diagnos-

most diseases by looking at tissue samples under a

Pathologists. He also travels the country spreading the

microscope. By assessing the appearance and behav-

word about these new findings, delivering presentations

ior of brain tumor cells, neuropathologists have clas-

to hospital leadership and teaching continuing medical

sified and graded gliomas to help clinicians determine

education courses to practitioners.

the best treatment plans for their patients. In 2015,



Brat led a study conducted by a team of more than 300

oncologists and neurosurgeons are reading

“Pathologists, neuro-oncologists, radiation

scientists from 44 institutions worldwide challenging

scientific papers and seeing reams of

that status quo.

molecular profiles on hundreds of



The investigators, part of the Cancer Genome

Atlas Research Network, analyzed the genetic makeup of samples from 293 adults with a lower-grade glioma, a broad and clinically unpredictable class of brain

brain tumor patients with tens of thousands of markers being clustered by computer algorithms,” he says. “They need guidance on what practical

tumor. Looking at molecular markers like mutations

clinical tests to perform to make

and gene deletions, the scientists were able to divide

these ­diagnoses.”

28

NORTHWESTERN M EDICIN E • WINTER 2018

Daniel Brat is spearheading transformations in the field of pathology.

MAGA ZIN E . N M .ORG

29



Classifying brain tumors is a theme



Brat earned his medical degree and

that has marked Brat’s career since his early

a PhD in biomedical sciences from Mayo

leader, Brat plans to grow the department’s residency program, add four new fellowships —

days as a fellow, when he first described a

Medical School in 1994 and then completed his

in gynecologic pathology, molecular pathology,

rare tumor now known as chordoid glioma.

residency and a fellowship at Johns Hopkins

transfusion medicine and microbiology — and

Over time it was accepted as a new entity

Hospital. After training, he accepted a faculty

continue recruiting and developing the faculty.

by the WHO and found to have a specific

position at Emory School of Medicine, where



genetic signature.

he remained for 17 years until joining Feinberg

talented. I’d like to shine a light on their suc-



“It’s been extremely satisfying seeing my

findings get implemented broadly and improv-

“Our faculty is extremely dedicated and

last September.

cesses, so they are more visible nationally and



internationally,” he says.

“Northwestern is a phenomenal institu-

ing clinical care worldwide. The whole process

tion, and I thought the pathology department,



is eye-opening and a bit addictive,” he admits.

with the right resources and leadership, could

experimental side of pathology. The depart-

Brat is also a strong proponent of the



become one of the nation’s best,” he says. “In

ment has a collection of investigators focused

expert in his field.

addition, the brain tumor group here has had a

primarily on mechanisms of inflammation, epi-



really exceptional rise, both in the Chicago area

thelial biology and cancer. In his own National

and nationally, and I was thrilled to become a

Institutes of Health-funded basic science lab,

James, PhD, professor of Neurological Surgery

part of that.”

Brat investigates the mechanisms that cause

and a collaborator of Brat’s. “His research



is at the forefront of the individualized

grew up in Minneapolis, Brat was also drawn



medicine movement for tailoring cancer

to Northwestern and Chicago for personal

genetic alterations of cancer is to understand

treatments to the unique characteristics of

reasons: His father, Paul Brat, ’63 MD, earned

how these influence biological behavior, so

individual tumors.”

his medical degree here, and his mother cur-

that we can devise better treatments,” he says.

That thirst for discovery has made Brat an “Dr. Brat is a recognized leader, both

nationally and internationally,” says C. David

diffuse gliomas to progress.

Though he was born in Detroit, and

“The next stage after characterizing

“Right now, a clinical study that demonstrates

rently lives in the city’s suburbs.

a two- or three-month increase in life expec-

THE MANY SIDES OF PATHOLOGY

tancy for a patient with glioblastoma will get

Broadly, the practice of pathology can be split

published in a very high profile journal. Big

into two branches: Anatomic pathologists

picture, that’s still a dismal prognosis. We’ve

examine biopsy and surgical resection

1

2

“The next stage after characterizing genetic alterations of cancer is to understand how these influence biological behavior, so that we can devise better treatments.”

got a lot more work to do.”

specimens and make



diagnoses based on

necrosis (cell death) and hypoxia (low oxygen)

what they see under the

trigger rapid progression of glioma. In another,

microscope in tandem with

Brat’s lab uses drosophila (fruit flies) — a

immunohistochemistry,

simplified genetic model — to study a gene

molecular analysis and

that leads to brain tumor growth when deleted.

other tests. Meanwhile,

“BRAT” for short.

manage the laboratories



that provide test results

favorite sports teams — picking up more every

that help guide patient

time he moves — goes to movies and plays, and listens to classical music.

the kinds of samples or diseases examined.

from work, which is a little bit danger-

“There’s been an explosion of informa-

tion about disease that didn’t exist 30 years

“But right now, I live four blocks away

ous, because I do love my job,” he says. “Pathologists really enjoy what they do, from

ago,” Brat says. “With cancer, for instance, it

providing expert diagnoses, to long days in

would be very difficult to be a generalist today

the lab, to teaching the next generation of

with expertise in breast cancer, leukemia and

­pathologists.”

lymphoma and brain tumor sub-classifications. It’s just too much information for a single mortal to carry.”

Feinberg’s Department of Pathology cur-

rently consists of 14 specialties, six main areas of research and nearly 100 faculty. As their

NORTHWESTERN M EDICIN E • WINTER 2018

For fun outside of work, Brat watches his

subspecialties within these branches, based on

30

Ironically, that gene is called “brain tumor,” or

clinical pathologists

care. There are also many

3

In one project, his team is exploring how

1: Cheryl Olson, laboratory manager, and Subhas Mukherjee, PhD, research assistant professor of Pathology, with Brat in his lab. | 2: Samples of brain tumor tissue in the “gross room” at Northwestern Memorial Hospital. | 3: Qinwen Mao, MD, PhD, associate professor of Pathology, and Alexa Derayunan, surgical pathology technologist, examine the samples with Brat to make a diagnosis.

LE ARN MORE ABOUT B R AT ’S RES E ARCH AT MAGA ZIN E . N M .ORG

ALUMNI

Alumni President’s Message

Alumni showed off their pride for Feinberg at tailgates and a board member reception last fall.

‘CATSMD’ Ideals A letter from Jim Kelly, ’73 MD

I

n my initial talk with our Medical Alumni Association

average debt of a Feinberg medical school graduate

Board (MAAB) last spring, I expanded the acronym

being $169,000, we’ve never been more aware of the

“MCATS” penned by Bruce Scharschmidt, ’70 MD,

former president of the MAAB, to “CATSMD.” Here I will explain the meaning of this new acronym.

need to support our Feinberg students. M MATTERS Northwestern and Feinberg should matter to all of us. While clearly the trajectory of the

C CULTURE We want the MAAB to encourage a culture

medical school is on the rise locally and nationally,

of commitment and giving back to Feinberg students,

Feinberg graduates should share some personal

graduates and GMEs. Each of us can give back in our own

responsibility to help catalyze change and positively

way: some by being home sponsors through our HOST

affect this moment in medicine. We encourage

program for fourth-year students, some by serving on the

participation and being a part of the evolving change

board, others by contributing to the Nathan Smith Davis

going on in medicine today.

Society or mentoring medical students and HPMEs about the journey ahead.

D DEDICATION We provide programming, services and opportunities dedicated to the ideals of Feinberg,

A ALIGNMENT To be successful, our board policies

professionalism and impacting the medical school

need to align with the priorities of the Feinberg adminis-

through scholarship, life-long learning and giving

tration and you, our alumni constituents. We expanded

back to the institution that links us all.

our Women in Medicine program with a tea and panel discussion at Alumni Weekend last year and will continue that program this year. We also started an MDs in Business seminar series with a successful inaugural event this fall. Aligning in this way, we amplify the MAAB’s message with

So many in our alumni base already work hard to move the “CATSMD” goals forward. Thank you for your hard work and generosity! Together we’re making a real difference at our medical school.

help from our full-time support staff. T TALENT In 2016, the MAAB recognized that we needed greater diversity on our board with respect to ethnic background, age and geography. We also needed a mechanism in place to have current Feinberg student leaders on the MAAB. Both of these priorities have been accomplished. We recruited 20 new MAAB members over the past two years and upgraded the geography, diversity and age of the board simultaneously. We also worked with the Student Senate to make their president a member of the MAAB. We like where we are in early 2018, but we have the mechanisms in place to adopt and change if we need to. S SUPPORT We help our students by encouraging scholarship support from individual classes as well as contributions from individuals and families. We have united around the concept of a tuition-free medical school. With the

MAGA ZIN E . N M .ORG

31

ALUMNI

Profile

Ora Hirsch Pescovitz, ’79 MD

Setting the

FOUNDATION O

WRIT TEN BY Amber Bemis

ra Hirsch Pescovitz, ’79 MD, credits her academic career at Northwestern University for laying the groundwork for her multifaceted career, including in her latest position as president of Oakland University in Rochester, Michigan. “I acquired many important skills during medical school — I became a more careful listener, more passionate and compassionate and more attentive to scientific data — all imperative throughout my entire medical career and now in my new role,” Pescovitz says. Along with playing a critical role in her career, Northwestern is the setting of many fond memories throughout Pescovitz’s life. She met her late husband, Mark Pescovitz, ’78 MD, on the first day of orientation week; she drank her very first cup of coffee during an overnight shift as a medical student worker at the Chicago Tribune; and she has watched her daughter Naomi Pescovitz, ’09 in journalism, her brother

32

NORTHWESTERN M EDICIN E • WINTER 2018

Profile

PESCOVITZ’S CAREER EVOLUTION 1979

1981

1988

2009

2014

2017

Graduated Northwestern with MD

Finished pediatric residency at Children’s Hospital National Medical Center and studied endocrinology at the National Institutes of Health

Started 21-year tenure at Indiana University

Became first female executive vice president for medical affairs at the University of Michigan

Became senior vice president and U.S. medical leader for Eli Lilly

Became president of Oakland University in Rochester, Michigan

Started residency at the University of Minnesota

Emmet Hirsch, ’88 MD, ’92 GME, sister-in-law Arica Hirsch, ’91 MD, ’92 GME, and other family members graduate from Northwestern. Needless to say, Pescovitz has a lot of Northwestern pride. Pescovitz began her academic career at Northwestern in the Honors Program in Medical Education (HPME), a cohort-style program where undergraduates complete a bachelor’s and medical degree in six years. “I loved being in the HPME,” she says. “Our class had a very collaborative spirit. We all thought about the well-being of our patients but also the well-being of each other, and many of us are still close even 40 years later.” In 1974, the HPME was considered progressive for the number of women who were a part of the program. Of the 60 students enrolled, 12 were women. “Some of my lifelong passions and leadership roles started in medical school. I was encouraged by faculty Arthur Veis and Jack Snarr to get involved in student activities such as the Organization of Student Representatives — this really sparked my love for university administration and played an enormous role in my student life and my long-term career,” Pescovitz says. After medical school, she and Mark married and both accepted residency positions at the University of Minnesota. Two years later they moved to Washington D.C., where she finished her pediatric residency at the Children’s Hospital 1 National Medical Center and then went on to study endocrinology at the National Institutes for Health. Following their time in Washington, D.C., the couple settled at Indiana University where she worked as an associate professor of pediatrics and he as a transplant surgeon. During her 21-year tenure at Indiana, Pescovitz rose through the ranks and held many leadership roles including executive

associate dean for research affairs, president and CEO of Riley Hospital for Children and interim vice president for research administration. She is also an accomplished investigator. Her work focuses on the physiologic and molecular mechanisms responsible for puberty 2 and growth disorders, with an emphasis on developing novel therapies for these conditions. Although she has published more than 190 research publications, she describes the moments in her career where she brought people together to collaborate as her proudest accomplishments. “While I was the dean of research, I was the PI on a $155 million grant called the Indiana Genomics Initiative — this was the largest grant the university had ever received — and it was my job to organize the faculty who would be conducting the work,” Pescovitz says. “This is what I am best at: inspiring others to do their finest work and bringing them together. I think this stems from my time at Northwestern where I saw collaboration succeed for the common good.” In 2009, she was recruited as the first female executive vice president for medical affairs at the University of Michigan, where she was in charge of collaboration and activities between the academic health system’s hospitals and health centers and its medical school. There she managed three hospitals, more than 120 health centers and clinics and the University of Michigan Medical School, and oversaw $3.3 billion in revenue and $490 million in research funding. During the winter of 2010, Pescovitz’s husband Mark was killed in a tragic car accident. “When this happened I had to think hard about how I wanted to spend the rest of my career,” she says.

“Our class had a very collaborative spirit. We all thought about the well-being of our patients but also the well-being of each other, and many of us are still close even 40 years later.”

After finishing her contract at Michigan in 2014, Pescovitz took a short sabbatical before being recruited to work at pharmaceutical company Eli Lilly in Indianapolis as the senior vice president and U.S. medical leader. There she focused on learning about the process of drug discovery. Knowing that her heart was in academia, in July 2017 Pescovitz 3 accepted a position at Oakland University, where she plans to focus on increasing research and the University’s strategic growth plan. As president, she PRESIDENTIAL plans to follow the lifelong PRINCIPLES leadership principles she (THE 8 Cs) calls her “8 Cs,” many Moral compass of which she says stem Compassion from ideas formed at Courage Northwestern. Contribution “My vision is to unlock Commitment the potential of individuals Communication and leave a lasting impact through the transformative Collaboration power of education and Creativity research,” she says.

Above: 1 Pescovitz celebrates graduation from medical school at Northwestern. 2 Lewis Landsberg, MD, former dean of the medical school, presents Pescovitz with the 2004 Distinguished Alumni Award. 3 Pescovitz reconnects with Melani Shaum, ’80 MD, during Alumni Weekend in 2015. MAGA ZIN E . N M .ORG

33

ALUMNI

Giving Resources are still needed to create a tuition-free medical school, endow the efforts of our talented faculty, and support our innovative research and teaching programs.

Campaign Update The generosity of thousands of alumni, faculty and friends is helping us impact the health of humankind.

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billion

SCHOLARSHIPS

$ 170 million

98%

21.3%

$1.72 billion raised of $1.75 billion goal

of $800 million goal raised for a tuition-free medical school

FACULTY CAMPAIGN

$3

million 100%

of Feinberg department chairs contributed

CAMPAIGN PRIORITIES

The cost of medical school

With the partnership of new and longtime

and living in Chicago are

shape my life and career as

benefactors, we are raising crucial funds to:

honestly tremendous.

an academic physician.

• Build out ten core institutes that bring together patient care, research, education, community service and advocacy • Build the new Louis A. Simpson and Kimberly K. Querrey Biomedical Research Center • Construct a centerpiece hospital and medical office facilities at Northwestern Medicine Lake Forest Hospital • Create endowed professorships that accelerate the efforts of our most accomplished and promising faculty physicians and scientists • Establish endowed and expendable innovation grants for breakthrough research • Create scholarships for our exceptional medical, PhD and physical therapy students, and nurses • Establish fellowships to support our best and brightest trainees *All numbers as of December 31, 2017.

34

NORTHWESTERN M EDICIN E • WINTER 2018

Northwestern has helped

With Dr. Betty Hahneman’s

I am a proud faculty member

generous support and

and alumnus, and I’m happy

that of so many other scholarship donors, my

to support this fundraising

fellow students and I can take out less loans

effort, both as a donor and advocate,

and, thus, have more options after graduation.

because I know that the funds we provide will

Having less debt will make it easier to focus on

support breakthrough medical education and

my passion for service rather than the pursuit

ultimately improve patient care and change

of financial gain. After medical school, I hope

people’s lives for the better.

to work as a clinician while working on health policy, perhaps in research or implementation.

Neil Stone, ’68 MD, ’74, ’75 GME Robert Bonow, MD, Professor of Medicine

I also will continue to advocate for patients and those who cannot even afford to be patients. Robert Tessier, Class of 2021 Betty M. Hahneman, MD, MPH, Scholar

67 new scholarships created during We Will. The Campaign for Northwestern Medicine

795 faculty members made a gift of any amount to Feinberg

153 different funds supported

PROGRESS NOTES



We’d love to hear from you! Please share your recent news, accomplishments and important milestones with us.

jacket and carried our black doctor bag. We also carried red rubber gloves, which had

1980s Richard B. Lanman, ’81 MD, a biotechnology

to be boiled and dried off to be sterile. At night,

entrepreneur, was named to the board of direc-

we went with a police escort.

tors for BIOLASE, Inc., a dental laser company.

Send your updates and high-resolution photos to [email protected]. We will publish them in an upcoming issue of the magazine.

We went in pairs with a nurse, and each

of us wore our short, white medical school

To this day, I still have my Maxwell

Street Dispensary diploma from the Chicago Maternity Center hanging on the wall of my office. I am still working as an OB-GYN for UCLA Health in Torrance, California.”

1

Boris Lushniak ’83 MD, MPH, was recognized by the American Medical Association (AMA) with a Distinguished Service Award for his contributions to the field of public health. Lushniak played an active role in government

Charles F. Koopmann Jr., ’69 MD, was presented with the Bicentennial Faculty Governance Lifetime Achievement Award at

1950s

the University of Michigan. Now retired from

Ruth Benson, ’55 BSN, writes, “I gradu-

sion of the Department of Otolaryngology and

ated with a BS in Nursing in 1955. I have been living in Fairbanks, Alaska, since 1960 and

the university, Koopman led the pediatric divialso served on the advisory board for intercollegiate athletics. 

retired from a position as a contract nurse

1

practitioner in family planning at the Fairbanks Regional Health Center in 1992. Before that, I had been a nurse practitioner in college health

1970s

at the University of Alaska Fairbanks. Most

James (Jim) E. Bourdeau, ’73 PhD, ’74 MD,

of my university work took place at St. Olaf College in Northfield, Minnesota, for the three years before I enrolled at Evanston Hospital in 1952. It all seems extremely remote now!”

received the Albert Nelson Marquis Lifetime Achievement Award from Marquis Who’s Who. Following a career that encompassed basic research in renal physiology, clinical practice in nephrology and kidney transplantation, and service on the American Board of Internal

1960s Michael L. Friedman, ’67 MD, shared memories from the Chicago Maternity Center after reading about a novel set there written by

Medicine’s Test-Writing Committee in the subspecialty of nephrology, Bourdeau has retired in Satellite Beach, Florida, while spending as much time as he can find in Quebec City, Canada.

“TO THIS DAY, I STILL HAVE MY MAXWELL STREET DISPENSARY DIPLOMA FROM THE CHICAGO MATERNITY CENTER HANGING ON THE WALL OF MY OFFICE.” -MICHAEL L. FRIEDMAN, ’67 MD

service for nearly 30 years, having served as U.S. Surgeon General (Acting) from July 2013 to

David Kerns, ’68 MD. Friedman writes, “We

David Green, MD, ’74 PhD, professor emeritus

December 2014. He was also Deputy Surgeon

spent two weeks going into the West Side

of Medicine in the Division of Hematology and

General from 2010 to 2013 and from 2014 to 2015, as well as assistant commissioner for

neighborhoods of Chicago to deliver babies

Oncology at Feinberg, was recently selected to

under the most primitive conditions — often

receive the “Walk in Our Shoes” Award from

counterterrorism policy for the U.S. Food and

without any electric lights. I can remember

the Bleeding Disorders Alliance of Illinois.

Drug Administration from 2004 to 2010. AMA

it as though it was yesterday. MAGA ZIN E . N M .ORG

35

ALUMNI

Progress Notes

3

2

4

“THIS PIVOT AND SWING DANCE BETWEEN responses, including his role commanding the only U. S. Government hospital in Liberia CAPILLARY CELL treating Ebola patients during the Ebola crisis OUTER MEMBRANES in 2015. In January 2017, Lushniak became AND MITOCHONDRIA dean of the University of Maryland School of Public Health. 2 PRODUCES POWERFUL FEEDBACK LOOPS THAT Janet Prokop Pregler, ’88 MD, received for the second time in her career the “Women of INCLUDE INTERSTITIAL the Year” award from the Los Angeles County SPACE MESENCHYMAL Board of Supervisors and The Los Angeles CELLS AND THE END County Commission for Women. Pregler is a nationally recognized educator ORGAN ITSELF.” Chair-Elect Jack Resneck, Jr., MD, recognized

Lushniak for his leadership in several disaster

and advocate in woman’s health. Director of the

Iris Cantor-UCLA Women’s Health Center and a professor of Clinical Medicine at UCLA she is co-editor of the textbook “Women’s Health: Principles and Clinical Practice.” She has developed educational programs on women’s health for the American College of Physicians, Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute, and

-ROBERT BUCKINGHAM, MD, ’79 GME

Michael H. Goldstein, ’93 MD, MBA, was appointed as chief medical officer for Ocular Therapeutix, a biopharmaceutical company focused on developing therapies for eye diseases and conditions. Raymond “Ramiro” Sanchez, ’94 MD, was presented with the Albert Nelson Marquis Lifetime Achievement Award. He is a trained psychiatrist who is senior vice president of global clinical development at Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey. Sheila Gujrathi, ’96 MD, was appointed to the board of directors and named as a strategic advisor for TP Therapeutics, Inc., a privately held, clinical-stage biopharmaceutical

Medicare & Medicaid Services Panel on

company focusing on addressing oncology

Hospital Outpatient Payment. The Preglers

drug resistance.

have three children, one currently a freshman at Northwestern University. They look forward to the upcoming alumni reunion and reuniting with classmates and friends.

2000s

the Department of Health and Human Services

Eugene Lin, ’07 MD, medical director of the

Office on Women’s Health.

Mercy Life Flight Network Mobile Stroke



Her husband Johnathan Pregler, ’88

MD, is a professor of Anesthesiology and

1990s

Unit and director of the annual Mercy Health Stroke Symposium, received a

director of Operative Services at UCLA. He

Malcolm M. Bilimoria, ’91 MD, ’98 GME, a

2017 “20 Under 4” Leadership Recognition

is past-president of the California Society of

surgical oncologist at Northwest Community

Award. The award recognizes individuals in

Anesthesiologists and active nationally with

Hospital in Arlington Heights, Illinois, com-

northwest Ohio and southeast Michigan under

the American Society of Anesthesiologists

pleted a 19,341-foot scale of Mount Kilimanjaro

the age of 40 who have distinguished them-

in October with his patient Ken Brown, a sur-

selves in their career and/or community.

as its representative on the Centers for

vivor of adenocarcinoma of the pancreas.

36

NORTHWESTERN M EDICIN E • WINTER 2018

3, 4

Progress Notes

2010s

Risk Factor data. Students reported exposure

Dance Blocks Aging while Decreasing Pain and

to violence and related stressors including

Fatigue” (July 2017, iUniverse), two years after

fighting, perceptions of safety and other high-

his first book “Hazing Aging.”

Frank A. Clark, ’10 MD, has been appointed

risk behaviors. The study found a much higher



to the Dean’s Council on Advancement for the

self-reported rate of gun carrying and a higher

the mechanics of how capillary cells actually

Virginia Tech Carilion School of Medicine. The

burden of violence exposure among Chicago

support two organ systems, as they go about

council is a committee of volunteers created to

respondents across all study waves. These

their business of sanitizing the interstitial

advance the stature of the medical school by

data predate the recent (2016) surge in Chicago

space and supporting the end organ. They ac-

providing guidance, assistance, advocacy and

shootings and homicides, yet the higher rate

complish this task with a dynamic and complex

He writes, ‘Rejuvenation!’ dives into

philanthropic investment in support of the

of gun carrying in Chicago may reflect easier

outer membrane receptor system that has a

school’s strategic objectives. 

access to firearms as well as more intensive

major feedback loop relationship with their

segregation, poverty and hopelessness than

mitochondria. As they increase their permea-

Samaa Kemal, ’17 MD, ’17 MPH, presented her

what was experienced by youth in other cities.

bility, mitochondria shift combustion to energy

culminating experience research paper at the

The paper will be published in an upcoming

to support active transport of immune arsenal

2017 22nd Annual Injury Free Coalition for

issue of Injury Epidemiology.

into the interstitial space. When outer mem-

Kids conference on December 1-3. Kemal’s

branes decrease immune arsenal trafficking,

presentation was awarded best research paper 

they cause mitochondria to shift combustion to

distinction. 

nitric oxide, which chain reacts a causes a com-



Kemal’s study evaluated trends and risk

factors over time for self-reported gun car-

GME

pletely different set of capillary cell operations.

This pivot and swing dance between cap-

Robert Buckingham, MD, ’79 GME, published

illary cell outer membranes and mitochondria

school students in Chicago, New York City and

his second book on chronic inflammation

produces powerful feedback loops that include

Los Angeles using 2007–2013 Youth Behavioral

called “Rejuvenation!: How the Capillary-Cell

interstitial space mesenchymal cells and the

rying among freshman and sophomore public

ALUMNI WEEKEND 2018 • APRIL 27 & 28

Not just for reunion classes! • Earn up to 6.25 CME Credits at forums • Attend our Women in Medicine Tea at the Drake Hotel • Enjoy a buffet from Gibson’s Steakhouse at our

For more information, please visit our website at www.feinberg.northwestern.edu/alumni/ alumni-weekend or call 312-503-8012.

Celebrate in Chicago All Alumni Reception & Dinner • Participate in our Young Alumni Social

MAGA ZIN E . N M .ORG

37

ALUMNI

Progress Notes

5

6

8

7

in Puerto Rico to provide medical expertise

end organ itself. Chronic inflammation within

She is the dean for clinical research at the

interstitial space disrupts these feedback loops

University of Chicago Medicine and Biological

and medication just two weeks after Hurricane

by cannibalizing the capillary cell from the

Sciences and a professor of Pediatrics and

Maria ravaged the island in September.

inside out by employing a combination of

section chief of Hematology/Oncology in the

Mizuno’s private practice, OMNI Healthcare,

vascular inflammatory free radicals and the

Department of Pediatrics.

body’s own immune arsenal.” Henry J. Przybylo, MD, ’85 GME, published “Counting Backwards: A Doctor’s Notes on Anesthesia,” a book that chronicles his career and thoughts about the specialty during his long career at Northwestern. Przybylo is an associate professor of Anesthesiology at Feinberg and a pediatric anesthesiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago. Julian Schink, MD, ’86 GME, joined Cancer Treatment Centers of America (CTCA) as chief of Gynecologic Oncology. He will also serve as medical director of Gynecologic Oncology and Medical Oncology at the CTCA at Midwestern Regional Medical Center in Zion, Illinois. Schink brings more than 30 years of oncology experience to the organization, specializing in surgery, chemotherapy, hormone therapy

serves a large Puerto Rican patient population

ERIC MIZUNO, MD, ’92 GME, HITCHED A RIDE ON A PRIVATE PLANE AND LANDED AT A CLOSED AIRPORT IN PUERTO RICO TO PROVIDE MEDICAL EXPERTISE AND MEDICATION JUST TWO WEEKS AFTER HURRICANE MARIA RAVAGED THE ISLAND IN SEPTEMBER.

and targeted therapy treatments for patients

E. Dale Abel, MD, PhD, ’92 GME, was elected

with gynecologic cancers. Schink will oversee

president-elect of the Endocrine Society. His

the national Gynecologic Oncology Program at

term will commence March 20, 2018, and his

CTCA, serving patients in the treatment of

presidential term will begin on March 20, 2019,

cervical, ovarian, uterine, and vaginal and

for one year. Abel is the Francois M. Abboud

vulvar cancers, as well as gestational tropho-

Chair in Internal Medicine at the University of

blastic diseases.

Iowa Carver College of Medicine.

5

6

in Chicago’s Humboldt Park, so he immediately felt called to respond to the overwhelming needs of the island’s residents. Mizuno is also a clinical assistant professor of Medicine in the Division of General Internal Medicine and Geriatrics at Feinberg.

7

Richard Lawrence Makowiec, MD, ’99 GME, joined Franciscan Physician Network Orthopedic Specialists, which is based in Indianapolis. Laure DeMattia, MD, ’03 GME, joined Norman Regional Health System, which is based in Oklahoma. DeMattia specializes in medical weight loss.

8

Melina Kibbe, MD, ’03 GME, received the prestigious Dr. Rodman L. Sheen and Thomas G. Sheen Award at the annual meeting of the New Jersey Chapter of the American College of Surgeons, held December 2, 2017, in Iselin, New Jersey. The Sheen Award is presented each year to honor individuals who have made outstanding contributions to the medical profession. Kibbe inspired attendees with her presentation of “When Mice are Men: Sex Bias in Surgical Research” during the meeting. 

Susan Cohn, MD, ’87 GME, was named to the

Eric Mizuno, MD, ’92 GME, hitched a ride on



board of directors for St. Baldrick’s Foundation.

a private plane and landed at a closed airport

National Academy of Medicine on October 14,

38

NORTHWESTERN M EDICIN E • WINTER 2018

Kibbe was elected as a member of the

Progress Notes

In Memoriam

Maurice K. Roskelley, ’56 MD Salt Lake City, Utah

Northwestern Medicine expresses its condolences to the families and friends of the following alumni (listed in order of their graduation year) and faculty who have recently passed away. All dates are in 2017.

SEPTEMBER 23

ALUMNI Sam A. Marascalco, ’43 DDS Tucson, Arizona FEBRUARY 1

Gerald O. McDonald, ’47 MD, ’48 GME Great Falls, Virginia OCTOBER 12

Robert W. Denton, ’47 MD Bishop, California OCTOBER 28

George R. Clutts, ’48 MD Greensboro, North Carolina SEPTEMBER 13

Mary M. Stoskopf, ’49 MS Overland Park, Kansas NOVEMBER 4

Charles H. Boggs Jr., ’50 MD, ’56 GME Roanoke, Virginia OCTOBER 8

E. Eliot Benezra, ’50 MD Oak Brook, Illinois OCTOBER 2

Charles Boggs Jr. ’50 MD, ’56 GME Roanoke, Virginia OCTOBER 8

Margaret P. Steinam, ’52 MD, ’54, ’56 GME Mequon, Wisconsin NOVEMBER 20

David Paul Cooney, ’54 MD Stanford, California SEPTEMBER 27

William R. Vogler, Jr., ’54 MD Decatur, Georgia

9

10

Dale R. Hines, ’57 MD Dayton, Ohio SEPTEMBER 19

Stanley M. Englander, ’59 MD Rockland, Maine OCTOBER 19

Pacita Manalo Estrella, ’63 MD Reno, Nevada OCTOBER 20

Emmett J. Sharkey, ’65 MD San Diego, California OCTOBER 8

Edward M. Katz, MD, ’65, ’66 GME Menlo Park, California SEPTEMBER 24

Norman K. Wood, ’66 MSD, ’68 PhD Perth, Ontario, Canada OCTOBER 21

Winston D. Crabb, ’67 MD Rio Rancho, New Mexico SEPTEMBER 30

Michael W. Witwer, ’67 MD, ’73 GME Santa Rosa, California SEPTEMBER 25

Robert Scott Zeiders, MD, ’67 MD Savoy, Illinois

2017. Election to the Academy is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.   9, 10 Richard Zorowitz, MD, ’09 GME, was named a 2017 Top Doctor in Washington, D.C. He is a physical medicine and rehabilitation physician with the MedStar National Rehabilitation Network. Hala Yamout, MD, ’13 GME, received the 2017 St. Louis Veteran Affairs (VA) Medical Staff Recognition Award. Yamout is a staff physician in the Department of Nephrology at the St. Louis VA.

NOVEMBER 24

Robert G. Cook, MD, ’78 GME Kenosha, Wisconsin SEPTEMBER 23

Susan M. Haack, MD, ’88 GME Anthem, Arizona DECEMBER 30

Thomas J. Mango, ’89 MD Granger, Indiana OCTOBER 3

DPT Patrick Blair, ’90 BSPT, joined Olympic Physical Therapy as a physical therapist. Blair has 27 years of outpatient orthopedic experience working in the south suburbs of Chicago. His area of clinical interest is hand and upper extremity rehabilitation.

Danielle Alana Peress, MD, ’16 GME New York, New York NOVEMBER 26

DECEMBER 2

MAGA ZIN E . N M .ORG

39

ALUMNI

Perspective WRIT TEN BY

William Weber, ’17 MD, ’17 MPH

MARK ONE OR MORE BOXES

A young alumnus debates the utility of clustering patients into demographic categories.

The category of Pacific Islander includes

certain groups have unequal outcomes. As

The 80-year-old woman came to my ER with



lower abdominal pain. I started thinking

less than 2 million people globally, while the

through my differential: diverticulitis, urinary

category Asian includes 4.5 billion and would

these patterns and seek to eliminate them.

tract infection, maybe appendicitis. Her labs

lump together the experiences of Chinese



came back showing nothing. During a second

and Indian Americans. If someone orders

mation daily to risk stratify patients while

round of questions, she mentioned a new

Asian food, they would be surprised if they

taking their history. There are many deter-

boyfriend at the nursing home. It turned

got dosas and tandoori chicken, which means

minants of health, and understanding the

physicians, we must both be cognizant of As a physician, I use demographic infor-

out that my frisky octogenarian had a case

that Grubhub somehow outpaces many

risk ratios associated with certain population

of chlamydia.

electronic health records at differentiating

groups helps to steer my workups. That being

people groups. Boxes reduce individuals to

said, individuals are unique. I anchored on

often ill-fitting categories that may not

my 80-year-old's likely diagnoses differently



We categorize people in medicine all the

time. Young, old, black, white, female, male, THESE BOXES AND I HAVE A bipolar relationship. I find boxes complicated because they are frustratingly inexact and reductionist but still point out significant societal trends to address.

this, that. Every demo-

reflect their experience.

because we less frequently associate sexually

graphic survey has a



transmitted infections with the elderly. It is

slew of boxes that tries

of inequality in populations, where large

to compartmentalize

sample sizes average out disparate individual

come from anywhere on the bell curve.

us as people. These

experiences. The ignoble groupings have a



boxes and I have a

brutal simplicity, yet still manage to reveal

parities between groups helps me advocate to

Boxes perform better in revealing trends

crucial to remember that our patients may At a population level, knowledge of dis-

bipolar relationship.

large disparities. What the roughhewn

eliminate those differences. I chose to pursue

I find boxes compli-

categories lack in specificity, they

a master of public health degree during

cated because they are

make up for in unearthing

medical school so that I could

frustratingly inexact and reductionist but still

areas to research: White

point out significant societal trends to address.

people are x times

parate epidemiol-



more likely to have

ogy of disease and

The analytical side of me contests

better understand the dis-

the boxes. What should be an orderly and

health insurance

address it through

intuitive grouping generally ends up a messy

than black people.

policy, especially

hodgepodge of categories forming an impossi-

The statistics

among victims of gun

ble Venn diagram.

shed light on

violence and the res-



Consider the U.S. government’s five

aspects of

identially displaced.

minimum categories for collecting data on

American life

My hope is that

race: American Indian or Alaska native, Asian,

in which

through advocacy

black or African American, Native Hawaiian or other Pacific Islander, and white — the race

and hard work, the demographic boxes

boxes are a mix of skin tone, people group and

that our patients check

geographic region. What about my Russian

will cease being risk

friends? Do they pick Asian to match geogra-

factors for disease.

phy or white to match skin color? Or friends from Algeria or Pakistan, both of whom the government unceremoniously dumps into the white category. 40

NORTHWESTERN M EDICIN E • WINTER 2018

ILLUSTR ATION BY Jérôme Mireault

Northwestern Medicine Through the Years

1583–present Artifacts from Special Collections RARE BOOKS

F

einberg’s Galter Health Sciences Library and Learning Center houses thousands of rare, unique and historical materials within its Special Collections Department. The collections include medical and dental works from European and American sources, spanning the 15th through the 20th centuries, with strengths in anatomy, pathology, obstetrics and gynecology, and urology, among other areas. The department also

RE AD MORE ABOUT TH ES E R ARE BOOKS IN OU R HISTORY B LOG AT MAGA ZIN E . N M .ORG

WARD ROUNDS

houses medical and dental artifacts, manuscripts, institutional and personal archives and more. Pictured above: The top nine images posted to the Special Collections’ Instagram account (galter_special_collections) in 2017. Among these pages are a municipal report on all the deaths reported in London in the year 1665, including “French Pox” and “Kings Evill” (third row, third column), and a 17th century medical book that attempts to classify deformities and congenital abnormalities, including those that afflict fantastical creatures (third row, second column).

Photos courtesy of Katie Lattal

MAGA ZIN E . N M .ORG

41

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